The acceptability of technology-enabled physical activity feedback in cardiac patients and health care professionals

Purpose: Physical activity is a key component of cardiac rehabilitation (CR). Despite the widely reported benefits of CR, uptake in the United Kingdom is still low. Alternative home-based and technology-facilitated delivery models are needed to improve CR uptake and physical activity. This study set out to explore patient and clinician views of personalised, multidimensional physical activity feedback and its potential use within CR. Methods: We developed graphics for the presentation of personalised multidimensional physical activity feedback from data collected through wrist-worn monitors. Thirteen cardiac patients and nine healthcare professionals recruited from South West England wore research grade physical activity monitors for seven days. Participants then attended semi-structured interviews during which personalised physical activity feedback was provided. Interviews were audio-recorded, transcribed, and analysed thematically. Results: Two main themes were derived from the data which covered: 1) the perceived value of multidimensional physical activity feedback, and 2) support needed to facilitate understanding. Within the first theme, participants acknowledged that multidimensional physical activity feedback was useful for monitoring progress, goal setting, and increasing self-awareness of physical activity behaviour among both patients and clinicians. Within theme two, the need for more guidance and support from clinicians to aid patient understanding and reassurance was highlighted, particularly for those with very low physical activity levels. Conclusions: Multidimensional physical activity feedback delivered using a technology-enabled approach was perceived as acceptable among patients and clinicians. This study provides insights into the potential novel use of technology-enabled physical activity feedback to support and expand the delivery of CR.</p

The relationship between weight-related indicators and depressive symptoms during adolescence and adulthood: results from two twin studies

Background: The association between weight and depressive symptoms is well established, but the direction of effects remains unclear. Most studies rely on body mass index (BMI) as the sole weight indicator, with few examining the aetiology of the association between weight indicators and depressive symptoms. // Methods: We analysed data from the Twins Early Development Study (TEDS) and UK Adult Twin Registry (TwinsUK) (7658 and 2775 twin pairs, respectively). A phenotypic cross-lagged panel model assessed the directionality between BMI and depressive symptoms at ages 12, 16, and 21 years in TEDS. Bivariate correlations tested the phenotypic association between a range of weight indicators and depressive symptoms in TwinsUK. In both samples, structural equation modelling of twin data investigated genetic and environmental influences between weight indicators and depression. Sensitivity analyses included two-wave phenotypic cross-lagged panel models and the exclusion of those with a BMI <18.5. // Results: Within TEDS, the relationship between BMI and depression was bidirectional between ages 12 and 16 with a stronger influence of earlier BMI on later depression. The associations were unidirectional thereafter with depression at 16 influencing BMI at 21. Small genetic correlations were found between BMI and depression at ages 16 and 21, but not at 12. Within TwinsUK, depression was weakly correlated with weight indicators; therefore, it was not possible to generate precise estimates of genetic or environmental correlations. // Conclusions: The directionality of the relationship between BMI and depression appears to be developmentally sensitive. Further research with larger genetically informative samples is needed to estimate the aetiological influence on these associations

Sds22, a PP1 phosphatase regulatory subunit, regulates epithelial cell polarity and shape [Sds22 in epithelial morphology]

<p>Abstract</p> <p>Background</p> <p>How epithelial cells adopt their particular polarised forms is poorly understood. In a screen for genes regulating epithelial morphology in <it>Drosophila</it>, we identified <it>sds22</it>, a conserved gene previously characterised in yeast.</p> <p>Results</p> <p>In the columnar epithelia of imaginal discs or follicle cells, mutation of <it>sds22 </it>causes contraction of cells along their apical-basal axis, resulting in a more cuboidal morphology. In addition, the mutant cells can also display altered cell polarity, forming multiple layers in follicle cells and leaving the epithelium in imaginal discs. In yeast, <it>sds22 </it>encodes a PP1 phosphatase regulatory subunit. Consistent with this, we show that <it>Drosophila </it>Sds22 binds to all four <it>Drosophila </it>PP1s and shares an overlapping phenotype with <it>PP1beta9c</it>. We also show that two previously postulated PP1 targets, Spaghetti Squash and Moesin are hyper-phosphorylated in <it>sds22 </it>mutants. This function is shared by the human homologue of Sds22, PPP1R7.</p> <p>Conclusion</p> <p>Sds22 is a conserved PP1 phosphatase regulatory subunit that controls cell shape and polarity.</p

The cytoskeletal motor proteins Dynein and MyoV direct apical transport of Crumbs

Crumbs (Crb in Drosophila; CRB1-3 in mammals) is a transmembrane determinant of epithelial cell polarity and a regulator of Hippo signalling. Crb is normally localized to apical cell-cell contacts, just above adherens junctions, but how apical trafficking of Crb is regulated in epithelial cells remains unclear. We use the Drosophila follicular epithelium to demonstrate that polarized trafficking of Crb is mediated by transport along microtubules by the motor protein Dynein and along actin filaments by the motor protein Myosin-V (MyoV). Blocking transport of Crb-containing vesicles by Dynein or MyoV leads to accumulation of Crb within Rab11 endosomes, rather than apical delivery. The final steps of Crb delivery and stabilisation at the plasma membrane requires the exocyst complex and three apical FERM domain proteins – Merlin, Moesin and Expanded – whose simultaneous loss disrupts apical localization of Crb. Accordingly, a knock-in deletion of the Crb FERMbinding motif (FBM) also impairs apical localization. Finally, overexpression of Crb challenges this system, creating a sensitized background to identify components involved in cytoskeletal polarization, apical membrane trafficking and stabilisation of Crb at the apical domain.Funded by the Francis Crick Institute and the Australian National University

Selecting committee witnesses: experts back the call for a more even gender balance

Democratic Audit recently published a new report which analysed the identity of select committee witnesses in view of their increasing prominence and influence. Our research found that there was a substantial gender imbalance between those who speak in front of committees. We asked a number of democracy experts to give their views on the research, the reasons for this disparity, the consequences for women’s role in public life and what, if anything, can be done to address the problem

Mood symptoms, neurodevelopmental traits, and their contributory factors in X-linked ichthyosis, ichthyosis vulgaris and psoriasis

Background High rates of adverse mood/neurodevelopmental traits are seen in multiple dermatological conditions, and can significantly impact patients’ quality of life. Understanding the sex-specific nature, magnitude, impact and basis of such traits in lesser-studied conditions like ichthyosis, is important for developing effective interventions. Objectives To a) quantify and compare relevant psychological traits, across males diagnosed with X-linked ichthyosis (XLI, n=54) or female XLI carriers (n=83), ichthyosis vulgaris (IV, male n=23, female n=59) or psoriasis (male n=30, female n=122) and b) to identify factors self-reported to contribute most towards depressive, anxious and irritability phenotypes. Methods Participants recruited via relevant charities or social media completed an online survey of established questionnaires. Data were compared to general population data, and were also analysed by sex and skin condition. Results The lifetime prevalence of mood disorder diagnoses across all groups, and neurodevelopmental disorder diagnoses in the XLI groups, was higher than in the general population. Groups exhibited similarly significantly-elevated recent mood symptoms (Cohen’s d: 0.95-1.28, p0.47, p≤0.002), and between feelings of stigmatisation and quality of life, particularly in males. Numerous factors were identified as contributing significantly to mood symptoms in a condition or sex-specific, or condition/sex-independent, manner. Conclusions Recognising mood/neurodevelopmental problems in ichthyosis and psoriasis, and addressing the predisposing factors identified herein, in clinical practice should benefit the mental health of affected individuals

What is psychosis? A meta-synthesis of inductive qualitative studies exploring the experience of psychosis

Qualitative studies have played an important role in elucidating the lived experience of psychosis and there has recently been an increase in the number of such studies. There is now an urgent need to draw together the findings of these studies. This paper performed a meta-synthesis of inductive qualitative peer-reviewed research into psychosis. Ninety-eight articles were identified for systematic appraisal. Four themes, ‘Losing’, ‘Identifying a need for, and seeking, help’, ‘Rebuilding and reforging’, and ‘Better than new: gifts from psychosis’, were identified. The important implications these themes for clinicians and future research are examined upon. These findings also highlight that the experience of psychosis is much more than simply just hallucinations and/or delusions

A cross‐lagged twin study of emotional symptoms, social isolation and peer victimisation from early adolescence to emerging adulthood

Background Emotional symptoms, such as anxiety and depressive symptoms, are common during adolescence, often persist over time, and can precede the emergence of severe anxiety and depressive disorders. Studies suggest that a vicious cycle of reciprocal influences between emotional symptoms and interpersonal difficulties may explain why some adolescents suffer from persisting emotional symptoms. However, the role of different types of interpersonal difficulties, such as social isolation and peer victimisation, in these reciprocal associations is still unclear. In addition, the lack of longitudinal twin studies conducted on emotional symptoms during adolescence means that the genetic and environmental contributions to these relationships during adolescence remain unknown. Methods Participants (N = 15,869) from the Twins Early Development Study completed self-reports of emotional symptoms, social isolation and peer victimisation at 12, 16 and 21 years old. A phenotypic cross-lagged model examined reciprocal associations between variables over time, and a genetic extension of this model examined the aetiology of the relationships between variables at each timepoint. Results First, emotional symptoms were reciprocally and independently associated with both social isolation and peer victimisation over time, indicating that different forms of interpersonal difficulties uniquely contributed to emotional symptoms during adolescence and vice versa. Second, early peer victimisation predicted later emotional symptoms via social isolation in mid-adolescence, indicating that social isolation may constitute an intermediate pathway through which peer victimisation predicts longer-term emotional symptoms. Finally, individual differences in emotional symptoms were mostly accounted for by non-shared environmental factors at each timepoint, and both gene–environment and individual-specific environmental mechanisms were involved in the relationships between emotional symptoms and interpersonal difficulties. Conclusions Our study highlights the necessity to intervene early in adolescence to prevent the escalation of emotional symptoms over time and to consider social isolation and peer victimisation as important risk factors for the long-term persistence of emotional symptoms

Spelling errors and shouting capitalization lead to additive penalties to trustworthiness of online health information: randomized experiment with laypersons

Background: The written format and literacy competence of screen-based texts can interfere with the perceived trustworthiness of health information in online forums, independent of the semantic content. Unlike in professional content, the format in unmoderated forums can regularly hint at incivility, perceived as deliberate rudeness or casual disregard toward the reader, for example, through spelling errors and unnecessary emphatic capitalization of whole words (online shouting). Objective: This study aimed to quantify the comparative effects of spelling errors and inappropriate capitalization on ratings of trustworthiness independently of lay insight and to determine whether these changes act synergistically or additively on the ratings. Methods: In web-based experiments, 301 UK-recruited participants rated 36 randomized short stimulus excerpts (in the format of information from an unmoderated health forum about multiple sclerosis) for trustworthiness using a semantic differential slider. A total of 9 control excerpts were compared with matching error-containing excerpts. Each matching error-containing excerpt included 5 instances of misspelling, or 5 instances of inappropriate capitalization (shouting), or a combination of 5 misspelling plus 5 inappropriate capitalization errors. Data were analyzed in a linear mixed effects model. Results: The mean trustworthiness ratings of the control excerpts ranged from 32.59 to 62.31 (rating scale 0-100). Compared with the control excerpts, excerpts containing only misspellings were rated as being 8.86 points less trustworthy, those containing inappropriate capitalization were rated as 6.41 points less trustworthy, and those containing the combination of misspelling and capitalization were rated as 14.33 points less trustworthy (P<.001 for all). Misspelling and inappropriate capitalization show an additive effect. Conclusions: Distinct indicators of incivility independently and additively penalize the perceived trustworthiness of online text independently of lay insight, eliciting a medium effect size