Stakeholder identified research priorities for early intervention in psychosis

BACKGROUND: Public resources to answer pertinent research questions about the impact of illness and treatment on people with mental health problems are limited. To target funds effectively and efficiently and maximize the health benefits to populations, prioritizing research areas is needed. Research agendas are generally driven by researcher and funder priorities, however, there is growing recognition of the need to include user‐defined research priorities to make research more relevant, needs‐based and efficient. OBJECTIVE: To gain consensus on top priorities for research into early intervention in psychosis through a robust, democratic process for prioritization enlisting the views of key stakeholders including users, carers and healthcare professionals. We also sought to determine which user‐prioritized questions were supported by scientific evidence. DESIGN AND METHODS: We used a modified nominal group technique to gain consensus on unanswered questions that were obtained by survey and ranked at successive stages by a steering group comprising users, carer representatives and clinicians from relevant disciplines and stakeholder bodies. We checked each question posed in the survey was unanswered in research by reviewing evidence in five databases (Medline, Cinahl, PsychInfo, EMBASE and Cochrane Database). RESULTS: Two hundred and eighty‐three questions were submitted by 207 people. After checking for relevance, reframing and examining for duplicates, 258 questions remained. We gained consensus on 10 priority questions; these largely represented themes around access and engagement, information needs before and after treatment acceptance, and the influence of service‐user (SU) priorities and beliefs on treatment choices and effectiveness. A recovery SUtheme identified specific self‐management questions and more globally, a need to fully identify factors that impact recovery. DISCUSSION AND CONCLUSIONS: Published research findings indicated that the priorities of service users, carers and healthcare professionals were aligned with researchers' and funders' priorities in some areas and misaligned in others providing vital opportunities to develop research agendas that more closely reflect users' needs. PATIENT AND PUBLIC CONTRIBUTION: Initial results were presented at stakeholder workshops which included service‐users, carers, health professionals and researchers during a consensus workshop to prioritize research questions and allow the opportunity for feedback. Patient and public representatives formed part of the steering group and were consulted regularly during the research process

Impacts of climate change on ocular health: A scoping review

Climate change represents a significant global health crisis, characterized by a complex interplay of environmental shifts and interconnected phenomena. These alterations have given rise to a multitude of health implications, notably impacting ocular health. Our comprehensive review delineates a spectrum of eye conditions associated with climate change-related variables. Extremes in temperature and weather events have been observed to affect the ocular surface, resulting in an increased incidence of conjunctivitis, keratitis, dry eye disease, and pterygium. Furthermore, climate change is linked to a rising occurrence of cataracts, glaucoma, periocular tumors, and infections. Prolonged food insecurity, stemming from droughts, has been associated with nutritional optic neuropathies and consequent vision loss. Elevated temperatures have also been correlated with a heightened risk of retinal detachments necessitating urgent surgical intervention to enhance prognostic outcomes.This review also outlines the influence of climate-warming pollutants on a diverse array of eye conditions, manifesting as ocular surface infections, degenerative changes like pterygium, cataracts, refractive errors (myopia), blepharitis, meibomian gland infections, glaucoma, and vascular retinal occlusions.Mitigating the effects of climate change is an urgent global imperative necessitating collaborative efforts, encompassing research and education, to devise sustainable solutions that safeguard human health and well-being. This review seeks to delineate the current extent of available research, identify gaps in the existing literature, and chart the course for future studies in this intriguing association

Greener Operations: a James Lind Alliance Priority Setting Partnership to define research priorities in environmentally sustainable perioperative practice through a structured consensus approach

Objectives: To agree on the ‘top 10’ research priorities for environmentally sustainable perioperative practice. Design: Surveys and literature review; final consensus workshop using a nominal group technique. Setting: UK-based setting. Participants: Healthcare professionals, patients, carers and the public. Outcome measures: Initial survey—suggested research questions; interim survey—shortlist of ‘indicative’ questions (the 20 most frequently nominated by patients, carers and the public, and healthcare professionals); final workshop—ranked research priorities. Results: Initial survey—1926 suggestions by 296 respondents, refined into 60 indicative questions. Interim survey—325 respondents. Final workshop—21 participants agreed the ‘top 10’: (1) How can more sustainable reusable equipment safely be used during and around the time of an operation? (2) How can healthcare organisations more sustainably procure (obtain) medicines, equipment and items used during and around the time of an operation? (3) How can healthcare professionals who deliver care during and around the time of an operation be encouraged to adopt sustainable actions in practice? (4) Can more efficient use of operating theatres and associated practices reduce the environmental impact of operations? (5) How can the amount of waste generated during and around the time of an operation be minimised? (6) How do we measure and compare the short-term and long-term environmental impacts of surgical and non-surgical treatments for the same condition? (7) What is the environmental impact of different anaesthetic techniques (eg, different types of general, regional and local anaesthesia) used for the same operation? (8) How should the environmental impact of an operation be weighed against its clinical outcomes and financial costs? (9) How can environmental sustainability be incorporated into the organisational management of operating theatres? (10) What are the most sustainable forms of effective infection prevention and control used around the time of an operation (eg, personal protective equipment, drapes, clean air ventilation)? Conclusions: A broad range of ‘end-users’ have identified research priorities for sustainable perioperative care

Anaplasma phagocytophilum Dihydrolipoamide Dehydrogenase 1 Affects Host-Derived Immunopathology during Microbial Colonization

Anaplasma phagocytophilum is a tick-borne rickettsial pathogen that provokes an acute inflammatory response during mammalian infection. The illness caused by A. phagocytophilum, human granulocytic anaplasmosis, occurs irrespective of pathogen load and results instead from host-derived immunopathology. Thus, characterizing A. phagocytophilum genes that affect the inflammatory process is critical for understanding disease etiology. By using an A. phagocytophilum Himar1 transposon mutant library, we showed that a single transposon insertion into the A. phagocytophilum dihydrolipoamide dehydrogenase 1 gene (lpda1 [APH_0065]) affects inflammation during infection. A. phagocytophilum lacking lpda1 revealed enlargement of the spleen, increased splenic extramedullary hematopoiesis, and altered clinicopathological abnormalities during mammalian colonization. Furthermore, LPDA1-derived immunopathology was independent of neutrophil infection and correlated with enhanced reactive oxygen species from NADPH oxidase and nuclear factor (NF)-κB signaling in macrophages. Taken together, these findings suggest the presence of different signaling pathways in neutrophils and macrophages during A. phagocytophilum invasion and highlight the importance of LPDA1 as an immunopathological molecule