Co‐creating system‐wide improvement for people with traumatic brain injury across one integrated care system in the United Kingdom to initiate a transformation journey through co‐production

Background and Objective There is a need for better integration of services across communities and sectors for people living with traumatic brain injury (TBI) to meet their complex needs. Building on insights gained from earlier pilot work, here we report the outcomes of a participatory workshop that sought to better understand the challenges, barriers and opportunities that currently exist within the care pathway for survivors of TBI. Methods A diverse range of stakeholders from the acute and rehabilitation care pathway and the health and social care system were invited to participate in a 3-h workshop. The participants worked in four mixed subgroups using practice development methodology, which promotes person-centred, inclusive and participatory action. Results Thematic analysis identified shared purposes and values that were used to produce a detailed implementation and impact framework for application at both the level of the care interface and the overarching integrated care system. A variety of enablers were identified that related to collective values and behaviours, case management, team leadership and integrated team working, workforce capability, evidence-based practice and resourcing. The clinical, economic, cultural and social outcomes associated with these enablers were also identified, and included patient safety, independence and well-being, reduced waiting times, re-admission rates, staff retention and professional development. Conclusion The co-produced recommendations made within the implementation and impact framework described here provide a means by which the culture and delivery of health and social care services can be better tailored to meet the needs of people living with TBI. We believe that the recommendations will help shape the formation of new services as well as the development of existing ones. Patient or Public Contribution Patient and public involvement have been established over a 10-year history of relationship building through a joint forum and events involving three charities representing people with TBI, carers, family members, clinicians, service users, researchers and commissioners, culminating in a politically supported event that identified concerns about the needs of people following TBI. These relationships formed the foundation for the interactive workshop, the focus of this publication

A systematic review of vestibular stimulation in post-stroke visual neglect.

Unilateral visual neglect is a condition that negatively impacts the lives of many stroke survivors. Studies have investigated different forms of vestibular stimulation as a potential therapy, but evidence is yet to be systematically reviewed. We therefore reviewed the effects of vestibular stimulation on outcomes of neglect and activities of daily living (ADL) for people with visual neglect. We searched relevant databases up until September 2022. Eligible articles included any form of vestibular stimulation, study design, or control condition. Included participants were 18 years or older, presenting with neglect following a haemorrhagic or ischaemic stroke. Relevant outcomes were clinically validated measures of neglect and ADL. Cochrane risk of bias tools were used to assess study quality. Meta-analyses and narrative methods were used to synthesize the data. Our search returned 17 relevant studies comprising 180 participants. Meta-analyses showed no difference between galvanic vestibular stimulation and sham conditions on outcomes, whereas caloric vestibular stimulation led to improvement compared to pre-stimulation scores. Narrative syntheses showed mixed results. Clinical and methodological heterogeneity was found both within and between studies. Overall, results were inconsistent regarding the effects of vestibular stimulation as a treatment for neglect. Further trials are warranted but require more careful methodological planning

Obstructive Sleep Apnea Syndrome Is Less Frequent in Patients With Well-Controlled Acromegaly Treated With Somatostatin Analogues, Pegvisomant or in Combination

Background: Obstructive sleep apnea (OSA) often occurs in patients with active acromegaly and improves after treatment. Less is known about the development of OSA in patients after a longer period of control treated with somatostatin analogues (SSA) and pegvisomant. Methods: Seventy-nine patients (12 females, 17 males; age 49 +/- 14 years; body mass index 29.9 +/- 5.4 kg/m(2); IGF-1 184 +/- 73 mu g/L; disease duration 13 +/- 8 years (mean +/- standard deviation)) with wellcontrolled acromegaly treated with SSA (38%), pegvisomant (38%) or in combination (24%) who underwent ambulatory polygraphy were included in a prospective multicenter cross-sectional study. Results: Fourteen percent had OSA (range of apnea-hypopnea index (AHI) 5 -15). Patients with OSA (AHI >= 5 vs. < 5) had a longer disease duration (16 +/- 1 vs. 12 +/- 8 years; P = 0.01) and were older (61 +/- 9 vs. 47 +/- 13 years; P = 0.037). The AHI of all patients correlated with age (P = 0.01; r = 0.44). No differences were seen in terms of BMI and Epworth sleepiness scale score. Previous transsphenoidal surgery and radiation had no impact of the detection of OSA. The duration of well-controlled acromegaly was 7 +/- 3 years. Conclusion: OSA in patients with well-controlled acromegaly treated with SSA, pegvisomant or in combination is less frequent (14%) than previously described. Early treatment to reduce the active disease period should be aimed to prevent OSA

Ethnic Association in Primary Systemic Vasculitis: A Systematic Review

Background: Literature described wide disparities in incidence and prevalence between different types of vasculitis. There were no comprehensive studies on ethnic or racial associations in all types of primary systemic vasculitis (PSV) in any published article, until this review commenced in 2020. The purpose of the review is to synthesize the evidence regarding the relation of ethnicity and the incidence and/or prevalence of different types of PSV. Methods: A total of 52 selected articles which include Clinical trials, cohorts, cross-sectional studies, case series, and case studies and have been published within the last 10 years in the human population, were reviewed by searching The Medline, PubMed, and Google Scholars databases using predefined keywords. The PRISMA diagrams were followed to identify relevant articles. The methodological qualities of the studies were assessed using the EPHPP tool. Finally, a summary of the evidence on the association between ethnic origin and PSV was painstakingly compiled. Results: The connection between ethnicity and different types of PSV has been found to be significantly diverse in this research such as vasculitis is more common in Asians and Scandinavians, Kawasaki disease and periarteritis nodules are more prevalent in Japanese and Alaska-natives, ANCA-associated vasculitis is more frequent in Caucasians, whereas Henoch-Schonlein purpura and Cogan syndrome more usual in Caucasians and Asians. Furthermore, Behçet's disease more commonly occurs on the "Silk Road", especially in Turkey. Conclusion: Genetic susceptibility and environmental elements could be the contributing factors to the global variation in the incidence and prevalence of primary systemic vasculitis

Emotional Correlates of Unirhinal Odor Identification

It seems self-evident that smell profoundly shapes emotion, but less clear is the nature of this interaction. Here we sought to determine whether the ability to identify odors co-varies with self-reported feelings of empathy and emotional expression recognition, as predicted if the two capacities draw on common resource. Thirty six neurotypical volunteers were administered the Alberta Smell Test, The Interpersonal Reactivity Index and an emotional expression recognition task. Statistical analyses indicated that feelings of emotional empathy positively correlated with odor discrimination in right nostril, while the recognition of happy and fearful facial expressions positively correlated with odor discrimination in left nostril. These results uncover new links between olfactory discrimination and emotion which, given the ipsilateral configuration of the olfactory projections, point towards intra- rather than inter-hemispheric interaction. The results also provide novel support for the proposed lateralisation of emotional empathy and the recognition of facial expression, and give reason to further explore the diagnostic sensitivity of smell tests because reduced sensitivity to others’ emotions can mark the onset of certain neurological diseases

Psychological well-being in Europe after the outbreak of war in Ukraine

The Russian invasion of Ukraine on February 24, 2022, has had devastating effects on the Ukrainian population and the global economy, environment, and political order. However, little is known about the psychological states surrounding the outbreak of war, particularly the mental well-being of individuals outside Ukraine. Here, we present a longitudinal experience-sampling study of a convenience sample from 17 European countries (total participants = 1,341, total assessments = 44,894, countries with >100 participants = 5) that allows us to track well-being levels across countries during the weeks surrounding the outbreak of war. Our data show a significant decline in well-being on the day of the Russian invasion. Recovery over the following weeks was associated with an individual’s personality but was not statistically significantly associated with their age, gender, subjective social status, and political orientation. In general, well-being was lower on days when the war was more salient on social media. Our results demonstrate the need to consider the psychological implications of the Russo-Ukrainian war next to its humanitarian, economic, and ecological consequences

A global experience-sampling method study of well-being during times of crisis : The CoCo project

We present a global experience-sampling method (ESM) study aimed at describing, predicting, and understanding individual differences in well-being during times of crisis such as the COVID-19 pandemic. This international ESM study is a collaborative effort of over 60 interdisciplinary researchers from around the world in the “Coping with Corona” (CoCo) project. The study comprises trait-, state-, and daily-level data of 7490 participants from over 20 countries (total ESM measurements = 207,263; total daily measurements = 73,295) collected between October 2021 and August 2022. We provide a brief overview of the theoretical background and aims of the study, present the applied methods (including a description of the study design, data collection procedures, data cleaning, and final sample), and discuss exemplary research questions to which these data can be applied. We end by inviting collaborations on the CoCo dataset

Differential Modulation of Beta-Adrenergic Receptor Signaling by Trace Amine-Associated Receptor 1 Agonists

Trace amine-associated receptors (TAAR) are rhodopsin-like G-protein-coupled receptors (GPCR). TAAR are involved in modulation of neuronal, cardiac and vascular functions and they are potentially linked with neurological disorders like schizophrenia and Parkinson's disease. Subtype TAAR1, the best characterized TAAR so far, is promiscuous for a wide set of ligands and is activated by trace amines tyramine (TYR), phenylethylamine (PEA), octopamine (OA), but also by thyronamines, dopamine, and psycho-active drugs. Unfortunately, effects of trace amines on signaling of the two homologous β-adrenergic receptors 1 (ADRB1) and 2 (ADRB2) have not been clarified yet in detail. We, therefore, tested TAAR1 agonists TYR, PEA and OA regarding their effects on ADRB1/2 signaling by co-stimulation studies. Surprisingly, trace amines TYR and PEA are partial allosteric antagonists at ADRB1/2, whereas OA is a partial orthosteric ADRB2-antagonist and ADRB1-agonist. To specify molecular reasons for TAAR1 ligand promiscuity and for observed differences in signaling effects on particular aminergic receptors we compared TAAR, tyramine (TAR) octopamine (OAR), ADRB1/2 and dopamine receptors at the structural level. We found especially for TAAR1 that the remarkable ligand promiscuity is likely based on high amino acid similarity in the ligand-binding region compared with further aminergic receptors. On the other hand few TAAR specific properties in the ligand-binding site might determine differences in ligand-induced effects compared to ADRB1/2. Taken together, this study points to molecular details of TAAR1-ligand promiscuity and identified specific trace amines as allosteric or orthosteric ligands of particular β-adrenergic receptor subtypes

A global experience‐sampling method study of well‐being during times of crisis: The CoCo project

We present a global experience-sampling method (ESM) study aimed at describing, predicting, and understanding individual differences in well-being during times of crisis such as the COVID-19 pandemic. This international ESM study is a collaborative effort of over 60 interdisciplinary researchers from around the world in the “Coping with Corona” (CoCo) project. The study comprises trait-, state-, and daily-level data of 7490 participants from over 20 countries (total ESM measurements = 207,263; total daily measurements = 73,295) collected between October 2021 and August 2022. We provide a brief overview of the theoretical background and aims of the study, present the applied methods (including a description of the study design, data collection procedures, data cleaning, and final sample), and discuss exemplary research questions to which these data can be applied. We end by inviting collaborations on the CoCo dataset

Language contact between Spanish and Mosetén: A study of grammatical integration

This publication is a comprehensive study of the grammatical elements borrowed from Spanish into Mosetén. The author addresses the ways in which these elements are integrated, divides them into different groups of elements and compares how these relate to other language contact situations (paying special attention to language contact situations where Spanish is the donor languages and in which similar types of loans appears). She then goes on to reflect on the reasons for why these elements are borrowed and discusses relevant processes at the onset and during the propagation of loans