ASCORBIC ACID AS A GROWTH ADJUVANT IN ENCAPSULATED PROTOCORM-LIKE-BODIES OF RHYNCHOSTYLIS RETUSA BL. (ORCHIDACEAE)

In the present study, effect of ascorbic acid, a known growth adjuvant on encapsulated protocorm-like-bodies (PLBs) of Rhynchostylis retusa Bl. was investigated. PLBs were encapsulated in calcium alginate (3.5% sodium alginate and 100mM calcium chloride) prepared in Mitra et al. (1976) basal medium and supplemented with different concentration of ascorbic acid (5, 10, 15, 20mM). The encapsulated PLBs were stored at 25°C. Their germination response and germination potential was evaluated after every 4 weeks on basal media. Control set of encapsulated PLBs, failed to germinate after 32 weeks. However, PLBs with 15mM ascorbic acid in the encapsulated matrix showed the best response; nearly 90% germinated even after 32 weeks of storage. The survival and germination frequency was directly proportional to the level of ascorbic acid in the alginate mix upto 15mM level but declined on further increase. Differentiation of PLBs into plantlet was better in synthetic seeds containing lower concentration of ascorbic acid (5mM) as compared to higher levels (15, 20mM) whereas multiplication of secondary PLBs was more pronounced at higher levels. Chlorophyll content was inversely proportional to the level of ascorbic acid in the nutrient mix; lush green PLBs were observed at low concentration of ascorbic acid (5mM). This study highlights the potential of ascorbic acid as an aid to growth and survival of encapsulated PLBs upon storage

A systematic review investigating fatigue, psychological and cognitive impairment following TIA and minor stroke:protocol paper

Approximately 20,000 people have a transient ischemic attack (TIA) and 23,375 have a minor stroke in England each year. Fatigue, psychological and cognitive impairments are well documented post-stroke. Evidence suggests that TIA and minor stroke patients also experience these impairments; however, they are not routinely offered relevant treatment. This systematic review aims to: (1) establish the prevalence of fatigue, anxiety, depression, post-traumatic stress disorder (PTSD) and cognitive impairment following TIA and minor stroke and to investigate the temporal course of these impairments; (2) explore impact on quality of life (QoL), change in emotions and return to work; (3) identify where further research is required and to potentially inform an intervention study

Identifying and assessing the benefits of interventions for postnatal depression: a systematic review of economic evaluations

Abstract Background Economic evaluations of interventions for postnatal depression (PND) are essential to ensure optimal healthcare decision-making. Due to the wide-ranging effects of PND on the mother, baby and whole family, there is a need to include outcomes for all those affected and to include health and non-health outcomes for accurate estimates of cost-effectiveness. This study aimed to identify interventions to prevent or treat PND for which an economic evaluation had been conducted and to evaluate the health and non-health outcomes included. Methods A systematic review was conducted applying a comprehensive search strategy across eight electronic databases and other sources. Full or partial economic evaluations of interventions involving preventive strategies (including screening), and any treatments for women with or at-risk of PND, conducted in OECD countries were included. We excluded epidemiological studies and those focussing on costs only. The included studies underwent a quality appraisal to inform the analysis. Results Seventeen economic evaluations met the inclusion criteria, the majority focused on psychological /psychosocial interventions. The interventions ranged from additional support from health professionals, peer support, to combined screening and treatment strategies. Maternal health outcomes were measured in all studies; however child health outcomes were included in only four of them. Across studies, the maternal health outcomes included were quality-adjusted-life-years gained, improvement in depressive symptoms, PND cases detected or recovered, whereas the child health outcomes included were cognitive functioning, depression, sleep and temperament. Non-health outcomes such as couples’ relationships and parent-infant interaction were rarely included. Other methodological issues such as limitations in the time horizon and perspective(s) adopted were identified, that were likely to result in imprecise estimates of benefits. Conclusions The exclusion of relevant health and non-health outcomes may mean that only a partial assessment of cost-effectiveness is undertaken, leading to sub-optimal resource allocation decisions. Future research should seek ways to expand the evaluative space of economic evaluations and explore approaches to integrate health and non-health outcomes for all individuals affected by this condition. There is a need to ensure that the time horizon adopted in studies is appropriate to allow true estimation of the long-term benefits and costs of PND interventions

Pilot RCT of the use of video interactive guidance with preterm babies

© 2016 Society for Reproductive and Infant Psychology. Objective: To assess the potential of video interaction guidance (VIG) to increase sensitivity in parents of preterm infants. Background: Parental sensitivity has been identified as explaining some but not all of the capacity of full-term infants for later affect-regulation via its impact on the infant’s attachment system. Video interaction guidance (VIG) appears to be a promising intervention to improve parental sensitivity. Methods: A pilot randomised control trial was undertaken of the effectiveness of VIG in improving parental sensitivity using the CARE-Index as a primary outcome measure. Secondary outcomes included parenting stress, depression and anxiety, and post-traumatic stress. Data were collected at baseline and post-intervention, and analysed on an intent-to-treat basis, using analyses of covariance. Results: Thirty-one parents of an infant born at 32 weeks or less gestation were recruited from a city neonatal intensive care unit (NICU). The results show large but non-significant differences favouring the intervention group for both parental sensitivity (d = 0.86; p = 0.069) and infant cooperativeness (d = 0.78; p = 0.10). There were also medium to large non-significant differences favouring the intervention group for depression (d = 0.33; p = 0.41), anxiety (d = 0.38; p = 0.30), and parenting stress (d = 0.87; p = 0.14). There was no difference between groups in the proportion of parents with post-traumatic stress disorder (RR: 1.05; 95% CI: 0.85–1.37). Conclusion: VIG appears to be a promising intervention with which to increase parental sensitivity in parents of preterm infants, but additional components explicitly targeting parental trauma may also be needed

A randomized controlled trial and economic evaluation of the Parents Under Pressure program for parents in substance abuse treatment

Background There is growing interest in the provision of parenting support to substance misusing parents. Methods This pragmatic, multi-center randomized controlled trial compared an intensive one-to-one parenting program (Parents under Pressure, PuP) with Treatment as Usual (TAU) in the UK. Parents were engaged in community-based substance misuse services and were primary caregivers of children less than 2.5 years of age. The primary outcome was child abuse potential, and secondary outcomes included measures of parental emotional regulation assessed at baseline, 6 and 12-months. A prospective economic evaluation was also conducted. Results Of 127 eligible parents, 115 met the inclusion criteria, and subsequently parents were randomly assigned to receive PuP (n = 48) or TAU (n = 52). Child abuse potential was significantly improved in those receiving the PuP program while those in TAU showed a deterioration across time in both intent-to-treat (p < 0.03) and per-protocol analyses (p < 0.01). There was also significant reliable change (recovery/improvement) in 30.6% of the PuP group compared with 10.3% of the TAU group (p < 0.02), and deterioration in 3% compared with 18% (p < 0.02). The probability that the program is cost-effective was approximately 51.8% if decision-makers are willing to pay £1000 for a unit improvement in the primary outcome, increasing to 98.0% at a £20,000 cost-effectiveness threshold for this measure. Conclusions Up to one-third of substance dependent parents of children under 3-years of age can be supported to improve their parenting, using a modular, one-to-one parenting program. Further research is needed

Frequency of anxiety after stroke: a systematic review and meta-analysis of observational studies.

BACKGROUND AND PURPOSE: Negative psychological outcomes occur frequently after stroke; however, there is uncertainty regarding the occurrence of anxiety disorders and anxiety symptoms after stroke. A systematic review of observational studies was conducted that assessed the frequency of anxiety in stroke patients using a diagnostic or screening tool. SUMMARY OF REVIEW: Databases were searched up to March 2011. A random effects model was used to summarize the pooled estimate. Statistical heterogeneity was assessed using the I(2) statistic. Forty-four published studies comprising 5760 stroke patients were included. The overall pooled estimate of anxiety disorders assessed by clinical interview was 18% (95%confidence interval 8-29%, I(2)  = 97%) and was 25% (95% confidence interval 21-28%, I(2)  = 90%) for anxiety assessed by rating scale. The Hospital Anxiety and Depression Scale-Anxiety subscale 'probable' and 'possible' cutoff scores were the most widely used assessment criteria. The combined rate of anxiety by time after stroke was: 20% (95% confidence interval 13-27%, I(2)  = 96%) within one-month of stroke; 23% (95% confidence interval 19-27%, I(2)  = 84%) one to five-months after stroke; and 24% (95% confidence interval 19-29%, I(2)  = 89%) six-months or more after stroke. CONCLUSION: Anxiety after stroke occurs frequently although methodological limitations in the primary studies may limit generalizability. Given the association between prevalence rates and the Hospital Anxiety and Depression Scale-Anxiety cutoff used in studies, reported rates could in fact underrepresent the extent of the problem. Additionally, risk factors for anxiety, its impact on patient outcomes, and effects in tangent with depression remain unclear

Mums 4 Mums : structured telephone peer-support for women experiencing postnatal depression. Pilot and exploratory RCT of its clinical and cost effectiveness.

BACKGROUND: Postnatal depression (PND) can be experienced by 13% of women who give birth, and such women often exhibit disabling symptoms, which can have a negative effect on the mother and infant relationship, with significant consequences in terms of the child's later capacity for affect regulation. Research has shown that providing support to mothers experiencing PND can help reduce their depressive symptoms and improve their coping strategies. The Mums4Mums study aims to evaluate the impact of telephone peer-support for women experiencing PND. METHODS/DESIGN: The study design adopts the MRC framework for the development and evaluation of complex interventions. Health visitors in Warwickshire and Coventry Primary Care Trusts are screening potential participants at the 8-week postnatal check using either the Edinburgh Postnatal Depression Scale (EPDS > = 10) or the three Whooley questions recommended by NICE (http://guidance.nice.org.uk/CG45). The Mums4Mums telephone support intervention is being delivered by trained peer-supporters over a period of four months. The primary outcome is depressive symptomatology as measured by the Edinburgh Postnatal Depression Scale. Secondary outcomes include mother-child interaction, dyadic adjustment, parenting sense of competence scale, and self-efficacy. Maternal perceptions of the telephone peer-support are being assessed using semi-structured interviews following the completion of the intervention. DISCUSSION: The proposed study will develop current innovative work in peer-led support interventions and telecare by applying existing expertise to a new domain (i.e. PND), testing the feasibility of a peer-led telephone intervention for mothers living with PND, and developing the relationship between the lay and clinical communities. The intervention will potentially benefit a significant number of patients and support a future application for a larger study to undertake a full evaluation of the clinical and cost effectiveness of telephone based peer-support for PND. TRIAL REGISTRATION: ISRCTN: ISRCTN91450073. The study has received a major funding grant from National Institute for Health Research (NIHR) (UK) - Research for Patient Benefit (RfPB) programme (ref: PB-PG-0407-13232)