Influence of loneliness and rejection sensitivity on threat sensitivity in romantic relationships in young and middle-aged adults

There are individual differences in sensitivity to threats, but no research has examined risk factors for threat sensitivity in romantic relationships (RTS). Both loneliness and rejection sensitivity are associated with threat sensitivity, but no studies have examined whether these factors are associated with RTS in particular. The current study examined the influence of loneliness and rejection sensitivity (RS) on RTS in two cohorts: 18-35 (n = 166) and over 35 year olds (n = 153). We examined relationships between the variables, but also examined whether RS had mediating and/or moderating effects on the relationship between loneliness and RTS. Results showed (1) loneliness and RS were positively associated with RTS, (2) RS mediated the relationship between loneliness and RTS, (3) loneliness was higher in the older group, and (4) for women loneliness was not dependent on relationship status, but men were lonelier and more sensitive to rejection if they were not in a romantic relationship. The results indicate that those who are lonely and higher on rejection sensitivity may need support in their romantic relationships to avoid a hypersensitivity to threats; this is particularly important for men, whose loneliness and RS were dependent on relationship status

Managing the Second Year of Your PHD: Data Collection and Upgrading from an MPhil to a PhD

Your PhD typically takes the following course: Getting to grips with the literature and necessary research skills in the first year, conversion to PhD status and data collection in the second year and third year dedicated to writing up the thesis. This article aims to provide guidance and information for the crucial second year

Switching anti-CGRP monoclonal antibodies in chronic migraine:real-world observations of erenumab, fremanezumab and galcanezumab

Objectives: The anti-calcitonin gene-related peptide monoclonal antibodies (anti-CGRP-mAb) are effective in migraine; however, few studies have examined the benefit of switching from one anti-CGRP-mAb to another. In order to better inform clinical practice in this situation, we present our real-world findings of switching anti-CGRP-mAb in chronic migraine. Methods: Individuals with chronic migraine that switched anti-CGRP-mAb treatment (erenumab, fremanezumab or galcanezumab) due to ineffectiveness or adverse effects were retrospectively identified. Headache diary data before and up to 6 months after anti-CGRP-mAb switch were analysed. Main outcome measures were monthly red days (days with headaches limiting activity or requiring triptans), headache days (days with any kind of headache), triptan use, other analgesic use and headache disability (Headache Impact Test-6 (HIT-6) score) at 3 months. Results: The analysis included 66 instances of switching among 54 individuals. There were non-significant reductions of −1.2 (−2.7, 0.3) red days from baseline at 3 months, with 10 individuals (15%) showing ≥50% improvement and 22 (33%) experiencing a ≥30% improvement. Improvements in headache days, triptan days, other painkiller use and HIT-6 score were non-significant. When individuals that switched due to side effects were excluded from the analysis, significant reductions in headache (Friedman p=0.044) and a trend for improvement in red days (Friedman p=0.083) were observed. With regard to side effects, on 12 occasions these improved or resolved on switching to a different anti-CGRP-mAb, while new symptoms were reported on eight occasions following a switch. Conclusion: We recorded modest improvements in headache outcomes, although significant results were only observed in those that switched anti-CGRP-mAb due to ineffectiveness. Switching may therefore be a viable option for these individuals

From scaling up to sustainability in HIV: potential lessons for moving forward

Background: In 30 years of experience in responding to the HIV epidemic, critical decisions and program characteristics for successful scale-up have been studied. Now leaders face a new challenge: sustaining large-scale HIV prevention programs. Implementers, funders, and the communities served need to assess what strategies and practices of scaling up are also relevant for sustaining delivery at scale. Methods: We reviewed white and gray literature to identify domains central to scaling-up programs and reviewed HIV case studies to identify how these domains might relate to sustaining delivery at scale. Results: We found 10 domains identified as important for successfully scaling up programs that have potential relevance for sustaining delivery at scale: fiscal support; political support; community involvement, integration, buy-in, and depth; partnerships; balancing flexibility/adaptability and standardization; supportive policy, regulatory, and legal environment; building and sustaining strong organizational capacity; transferring ownership; decentralization; and ongoing focus on sustainability. We identified one additional potential domain important for programs sustaining delivery at scale: emphasizing equity. Conclusions: Today, the public and private sector are examining their ability to generate value for populations. All stakeholders are aiming to stem the tide of the HIV epidemic. Implementers need a framework to guide the evolution of their strategies and management practices. Greater research is needed to refine the domains for policy and program implementers working to sustain HIV program delivery at scale

Literature review of visual representation of the results of benefit–risk assessments of medicinal products

Background The PROTECT Benefit–Risk group is dedicated to research in methods for continuous benefit–risk monitoring of medicines, including the presentation of the results, with a particular emphasis on graphical methods. Methods A comprehensive review was performed to identify visuals used for medical risk and benefit–risk communication. The identified visual displays were grouped into visual types, and each visual type was appraised based on five criteria: intended audience, intended message, knowledge required to understand the visual, unintentional messages that may be derived from the visual and missing information that may be needed to understand the visual. Results Sixty-six examples of visual formats were identified from the literature and classified into 14 visual types. We found that there is not one single visual format that is consistently superior to others for the communication of benefit–risk information. In addition, we found that most of the drawbacks found in the visual formats could be considered general to visual communication, although some appear more relevant to specific formats and should be considered when creating visuals for different audiences depending on the exact message to be communicated. Conclusion We have arrived at recommendations for the use of visual displays for benefit–risk communication. The recommendation refers to the creation of visuals. We outline four criteria to determine audience–visual compatibility and consider these to be a key task in creating any visual. Next we propose specific visual formats of interest, to be explored further for their ability to address nine different types of benefit–risk analysis information

Journey to work:exploring difficulties, solutions and the impact of aging

A study was conducted in the UK, as part of the New Dynamics of Ageing Working Late project, of the journey to work among 1215 older workers (age groups 45-49, 50-55, 56-60 and 60 + ). The aim was to identify problems or concerns that they might have with their commute, strategies that have been adopted to address them, and the role that employers can play to assist them. Follow-up interviews with 36 employees identified many strategies for assisting with the problems of journeys to work, ranging from car share and using public transport to flexible working and working some days from home. Further interviews with a sample of 12 mainly larger companies showed that employers feel a responsibility for their workers’ commute, with some offering schemes to assist them, such as adjusting work shift timings to facilitate easier parking. The research suggests that the journey to work presents difficulties for a significant minority of those aged over 45, including issues with cost, stress, health, fatigue and journey time. It may be possible to reduce the impact of these difficulties on employee decisions to change jobs or retire by assisting them to adopt mitigating strategies. It does not appear that the likelihood of experiencing a problem with the journey to work increases as the employee approaches retirement; therefore, any mitigating strategy is likely to help employees of all ages. These strategies have been disseminated to a wider audience through an online resource at www.workinglate.org

Mutations in FRMD7, a newly identified member of the FERM family, cause X-linked idiopathic congenital nystagmus.

Idiopathic congenital nystagmus is characterized by involuntary, periodic, predominantly horizontal oscillations of both eyes. We identified 22 mutations in FRMD7 in 26 families with X-linked idiopathic congenital nystagmus. Screening of 42 singleton cases of idiopathic congenital nystagmus (28 male, 14 females) yielded three mutations (7%). We found restricted expression of FRMD7 in human embryonic brain and developing neural retina, suggesting a specific role in the control of eye movement and gaze stability

The Bristol Method: Green Capital Student Capital - The power of student sustainability engagement

THE BRISTOL METHODThe Bristol Method is a knowledge-transfer programme aimed at helping people in other cities understand and apply the lessons that Bristol has learned in becoming a more sustainable city, not just in 2015 but in the last decade. Each module of the Bristol Method is presented as an easy-to-digest ‘how to’ guide on a particular topic, which use Bristol’s experiences as a case study. The modules contain generic advice and recommendations that each reader can tailor to their own circumstances.This module focusses on the Green Capital: Student Capital project, and explains how the University of the West of England, Bristol (UWE) and the University of Bristol – with their respective students’ unions – have been working in partnership with the city and local communities, using Higher Education Funding Council for England Catalyst funding to promote student involvement in Green Capital activities across Greater Bristol.Student Capital created a broad programme of citywide impact during European Green Capital. It delivered a programme of student and staff engagement in enhancing sustainability within the city and has developed student and staff engagement with sustainability action. Through action research approaches it is also providing lessons for how institutions can collaborate across cities and communities to have internal and external impacts for sustainability. This report is for anyone seeking to increase sustainability engagement. In it we tell the story of the Student Capital project, explaining the processes and the outcomes, and suggesting pieces of advice and lessons for what went well, and what could have been done better or differently

30-day mortality after systemic anticancer treatment for breast and lung cancer in England: a population-based, observational study

Background: 30-day mortality might be a useful indicator of avoidable harm to patients from systemic anticancer treatments, but data for this indicator are limited. The Systemic Anti-Cancer Therapy (SACT) dataset collated by Public Health England allows the assessment of factors affecting 30-day mortality in a national patient population. The aim of this first study based on the SACT dataset was to establish national 30-day mortality benchmarks for breast and lung cancer patients receiving SACT in England, and to start to identify where patient care could be improved. Methods: In this population-based study, we included all women with breast cancer and all men and women with lung cancer residing in England, who were 24 years or older and who started a cycle of SACT in 2014 irrespective of the number of previous treatment cycles or programmes, and irrespective of their position within the disease trajectory. We calculated 30-day mortality after the most recent cycle of SACT for those patients. We did logistic regression analyses, adjusting for relevant factors, to examine whether patient, tumour, or treatment-related factors were associated with the risk of 30-day mortality. For each cancer type and intent, we calculated 30-day mortality rates and patient volume at the hospital trust level, and contrasted these in a funnel plot. Findings: Between Jan 1, and Dec, 31, 2014, we included 23 228 patients with breast cancer and 9634 patients with non-small cell lung cancer (NSCLC) in our regression and trust-level analyses. 30-day mortality increased with age for both patients with breast cancer and patients with NSCLC treated with curative intent, and decreased with age for patients receiving palliative SACT (breast curative: odds ratio [OR] 1·085, 99% CI 1·040–1·132; p<0·0001; NSCLC curative: 1·045, 1·013–1·079; p=0·00033; breast palliative: 0·987, 0·977–0·996; p=0·00034; NSCLC palliative: 0·987, 0·976–0·998; p=0·0015). 30-day mortality was also significantly higher for patients receiving their first reported curative or palliative SACT versus those who received SACT previously (breast palliative: OR 2·326 99% CI 1·634–3·312; p<0·0001; NSCLC curative: 3·371, 1·554–7·316; p<0·0001; NSCLC palliative: 2·667, 2·109–3·373; p<0·0001), and for patients with worse general wellbeing (performance status 2–4) versus those who were generally well (breast curative: 6·057, 1·333–27·513; p=0·0021; breast palliative: 6·241, 4·180–9·319; p<0·0001; NSCLC palliative: 3·384, 2·276–5·032; p<0·0001). We identified trusts with mortality rates in excess of the 95% control limits; this included seven for curative breast cancer, four for palliative breast cancer, five for curative NSCLC, and seven for palliative NSCLC. Interpretation: Our findings show that several factors affect the risk of early mortality of breast and lung cancer patients in England and that some groups are at a substantially increased risk of 30-day mortality. The identification of hospitals with significantly higher 30-day mortality rates should promote review of clinical decision making in these hospitals. Furthermore, our results highlight the importance of collecting routine data beyond clinical trials to better understand the factors placing patients at higher risk of 30-day mortality, and ultimately improve clinical decision making. Our insights into the factors affecting risk of 30-day mortality will help treating clinicians and their patients predict the balance of harms and benefits associated with SACT. Funding: Public Health England

Constraints from observations and modeling on atmosphere-surface exchange of mercury in eastern North America

Atmosphere-surface exchange of mercury, although a critical component of its global cycle, is currently poorly constrained. Here we use the GEOS-Chem chemical transport model to interpret atmospheric Hg-0 (gaseous elemental mercury) data collected during the 2013 summer Nitrogen, Oxidants, Mercury and Aerosol Distributions, Sources and Sinks (NOMADSS) aircraft campaign as well as ground-and ship-based observations in terms of their constraints on the atmosphere-surface exchange of Hg-0 over eastern North America. Model-observation comparison suggests that the Northwest Atlantic may be a net source of Hg-0, with high evasion fluxes in summer (our best sensitivity simulation shows an average oceanic Hg-0 flux of 3.3 ng m(-2) h(-1) over the Northwest Atlantic), while the terrestrial ecosystem in the summer of the eastern United States is likely a net sink of Hg-0 (our best sensitivity simulation shows an average terrestrial Hg-0 flux of -0.6 ng m(-2) h(-1) over the eastern United States). The inferred high Hg-0 fluxes from the Northwest Atlantic may result from high wet deposition fluxes of oxidized Hg, which are in turn related to high precipitation rates in this region. We also find that increasing simulated terrestrial fluxes of Hg-0 in spring compared to other seasons can better reproduce observed seasonal variability of Hg-0 concentration at ground-based sites in eastern North America.Peer reviewe