1,030 research outputs found
Investigating Neural Mechanisms Associated With the Double Empathy Problem Using fNIRS Hyperscanning
The Double Empathy Problem posits that autistic social difficulties are due to differences in communication styles rather than an autistic deficit in theory of mind (ToM). We used fNIRS hyperscanning to examine whether neural synchrony in pairs with varying levels of autistic traits during social interactions supports the Double Empathy Problem. Participants with low and high autistic trait expression were paired creating High-High, Low-High, and Low-Low groups. Pairs completed two trials where they 1) listened to and 2) discussed stories that contained or lacked theory of mind elements, while brain activity was recorded within the ToM network. During conversation, High-High pairs were less synchronous than Low-High pairs, but more synchronous than Low-Low pairs. We found significant synchrony for High-High pairs in ToM network during three of four conditions. Although we failed to find evidence in support the Double Empathy Problem, our results provide evidence against autism-specific theory of mind deficits
Serostatus disclosure among adults with HIV in the era of HIV therapy
Serostatus disclosure is an important component of secondary HIV prevention with potential benefits for both the individual by experiencing increased social support and society by reducing HIV transmission risk behaviors. This cross-sectional study assessed disclosure patterns to sex partners, family members, and friends by sociodemographic and HIV-related factors among an urban, Midwestern U.S. HIV clinic population (n=809); a majority of whom were African American and male with a mean age of 41 years. Almost three quarters (n=596) of the sample was currently receiving HIV therapy, with 68% (n=404) successfully suppressing their HIV viral loads. Among sexually activity individuals, 97% reported disclosing their serostatus to sex partners. This high rate of disclosure to sex partners suggests that social desirability may play a role in this self-reported measure. Approximately half of the sample (n=359) disclosed to at least one family member and 60% (n=474) disclosed to at least one friend. Disclosing to family members occurred more often among participants who were unemployed and endorsed depressive disorder symptoms (p<0.05 for all). Disclosing to friends occurred more frequently among women, Caucasians and those who completed higher levels of education (p<0.001 for all). HIV disclosure and disease severity were unassociated. Given the chronic nature of HIV care, additional research is needed to develop interventions to facilitate timely disclosure of HIV serostatus
Effects of a demand-led evidence briefing service on the uptake and use of research evidence by commissioners of health services:A controlled before-and-after study
Background: The Health and Social Care Act 2012 has mandated research use as a core consideration of health service commissioning arrangements. We evaluated whether or not access to a demand-led evidence briefing service improved use of research evidence by commissioners compared with less intensive and less targeted alternatives. Design: Controlled before-and-after study. Setting: Clinical Commissioning Groups (CCGs) in the north of England. Main outcome measures: Change at 12 months from baseline of a CCG’s ability to acquire, assess, adapt and apply research evidence to support decision-making. Secondary outcomes measured individual clinical leads’ and managers’ intentions to use research evidence in decision-making. Methods: Nine CCGs received one of three interventions: (1) access to an evidence briefing service; (2) contact plus an unsolicited push of non-tailored evidence; or (3) an unsolicited push of non-tailored evidence. Data for the primary outcome measure were collected at baseline and 12 months post intervention, using a survey instrument devised to assess an organisation’s ability to acquire, assess, adapt and apply research evidence to support decision-making. In addition, documentary and observational evidence of the use of the outputs of the service was sought and interviews with CCG participants were undertaken. Results: Most of the requests were conceptual; they were not directly linked to discrete decisions or actions but intended to provide knowledge about possible options for future actions. Symbolic use to justify existing decisions and actions were less frequent and included a decision to close a walk-in centre and to lend weight to a major initiative to promote self-care already under way. The opportunity to impact directly on decision-making processes was limited to work to establish disinvestment policies. In terms of impact overall, the evidence briefing service was not associated with increases in CCGs’ capacity to acquire, assess, adapt and apply research evidence to support decision-making, individual intentions to use research findings or perceptions of CCGs’ relationships with researchers. Regardless of the intervention received, at baseline participating CCGs indicated that it felt it was inconsistent in its research-seeking behaviours and its capacity to acquire research remained so at follow-up. The informal nature of decision-making processes meant that there was little or no traceability of the use of evidence. Limitations: Low baseline and follow-up response rates (of 68% and 44%, respectively) and missing data limit the reliability of these findings. Conclusions: Access to a demand-led evidence briefing service did not improve the uptake and use of research evidence by NHS commissioners compared with less intensive and less targeted alternatives. Commissioners appear to be well intentioned but ad hoc users of research. Future work: Further research is required on the effects of interventions and strategies to build individual and organisational capacity to use research. Resource-intensive approaches to providing evidence may best be employed to support instrumental decision-making. Comparative evaluation of the impact of less intensive but targeted strategies on the uptake and use of research by commissioners is warranted. Funding: National Institute for Health Research Health Services and Delivery Research programme
Investigating the prostate specific antigen, body mass index and age relationship:is an age–BMI-adjusted PSA model clinically useful?
Purpose
Previous studies indicate a possible inverse relationship between prostate-specific antigen (PSA) and body mass index (BMI), and a positive relationship between PSA and age. We investigated the associations between age, BMI, PSA, and screen-detected prostate cancer to determine whether an age–BMI-adjusted PSA model would be clinically useful for detecting prostate cancer.
Methods
Cross-sectional analysis nested within the UK ProtecT trial of treatments for localized cancer. Of 18,238 men aged 50–69 years, 9,457 men without screen-detected prostate cancer (controls) and 1,836 men with prostate cancer (cases) met inclusion criteria: no history of prostate cancer or diabetes; PSA\10 ng/ml; BMI between 15 and 50 kg/m2. Multivariable linear regression models were used to investigate the relationship between log-PSA, age, and BMI in all men, controlling for prostate cancer status.
Results
In the 11,293 included men, the median PSA was 1.2 ng/ml (IQR: 0.7–2.6); mean age 61.7 years (SD 4.9); and mean BMI 26.8 kg/m2 (SD 3.7). There were a 5.1% decrease in PSA per 5 kg/m2 increase in BMI (95% CI 3.4–6.8) and a 13.6% increase in PSA per 5-year increase in age (95% CI 12.0–15.1). Interaction tests showed no evidence for different associations between age, BMI, and PSA in men above and below 3.0 ng/ml (all p for interaction [0.2). The age–BMI-adjusted PSA model performed as well as an age-adjusted model based on National Institute for Health and Care Excellence (NICE) guidelines at detecting prostate cancer.
Conclusions
Age and BMI were associated with small changes in PSA. An age–BMI-adjusted PSA model is no more clinically useful for detecting prostate cancer than current NICE guidelines. Future studies looking at the effect of different variables on PSA, independent of their effect on prostate cancer, may improve the discrimination of PSA for prostate cancer.</p
Integration of primary care and palliative care services to improve equality and equity at the end-of-life:Findings from realist stakeholder workshops
Background: Inequalities in access to palliative and end of life care are longstanding. Integration of primary and palliative care has the potential to improve equity in the community. Evidence to inform integration is scarce as research that considers integration of primary care and palliative care services is rare. Aim: To address the questions: ‘how can inequalities in access to community palliative and end of life care be improved through the integration of primary and palliative care, and what are the benefits?’ Design: A theory-driven realist inquiry with two stakeholder workshops to explore how, when and why inequalities can be improved through integration. Realist analysis leading to explanatory context(c)-mechanism(m)-outcome(o) configurations(c) (CMOCs). Findings: A total of 27 participants attended online workshops (July and September 2022): patient and public members (n=6), commissioners (n=2), primary care (n=5) and specialist palliative care professionals (n=14). Most were White British (n=22), other ethnicities were Asian (n=3), Black African (n=1) and British mixed race (n=1). Power imbalances and racism hinder people from ethnic minority backgrounds accessing current services. Shared commitment to addressing these across palliative care and primary care is required in integrated partnerships. Partnership functioning depends on trusted relationships and effective communication, enabled by co-location and record sharing. Positive patient experiences provide affirmation for the multi-disciplinary team, grow confidence and drive improvements. Conclusions: Integration to address inequalities needs recognition of current barriers. Integration grounded in trust, faith and confidence can lead to a cycle of positive patient, carer and professional experience. Prioritising inequalities as whole system concern is required for future service delivery and research. <br/
Broadening our Understanding of Adversarial Growth: The Contribution of Narrative Methods
After adversity, individuals sometimes report adversarial growth - positive changes in their identity, relationships, and worldviews. We examined how narrative methods enhanced understanding of adversarial growth compared to standard questionnaires. Participants (N = 411) from college and community samples reported on their well-being, wrote a narrative about a highly challenging experience, and answered questionnaires on adversarial growth. Results showed that adversarial growth coded in narratives was positively associated with widely used self-report questionnaires of adversarial growth. Unexpectedly, narrative growth did not predict incremental validity in well-being outcomes compared to standard questionnaires. We found unique expressions of adversarial growth in a qualitative analysis of the narratives. We discuss the added value of using narratives for the assessment of adversarial growth
Abrogation of Stem Loop Binding Protein (Slbp) function leads to a failure of cells to transition from proliferation to differentiation, retinal coloboma and midline axon guidance deficits
Through forward genetic screening for mutations affecting visual system development, we identified prominent coloboma and cell-autonomous retinal neuron differentiation, lamination and retinal axon projection defects in eisspalte (ele) mutant zebrafish. Additional axonal deficits were present, most notably at midline axon commissures. Genetic mapping and cloning of the ele mutation showed that the affected gene is slbp, which encodes a conserved RNA stem-loop binding protein involved in replication dependent histone mRNA metabolism. Cells throughout the central nervous system remained in the cell cycle in ele mutant embryos at stages when, and locations where, post-mitotic cells have differentiated in wild-type siblings. Indeed, RNAseq analysis showed down-regulation of many genes associated with neuronal differentiation. This was coincident with changes in the levels and spatial localisation of expression of various genes implicated, for instance, in axon guidance, that likely underlie specific ele phenotypes. These results suggest that many of the cell and tissue specific phenotypes in ele mutant embryos are secondary to altered expression of modules of developmental regulatory genes that characterise, or promote transitions in, cell state and require the correct function of Slbp-dependent histone and chromatin regulatory genes
Addressing uncertainty in marine resource management; combining community engagement and tracking technology to characterize human behavior
This study was approved by the University of Exeter Ethics committee and the Ministry of Scientific Research and Technological Innovation in Congo (Permit: No. 023/MRSIT/DGRST/DMAST); and supported by funding from the Darwin Initiative (Projects 20-009 and 23-011) and the Wildlife Conservation Society.Small-scale fisheries provide an essential source of food and employment for coastal communities, yet the availability of detailed information on the spatiotemporal distribution of fishing effort to support resource management at a country level is scarce. Here, using a national-scale study in the Republic of Congo, we engaged with fishers from 23 of 28 small-scale fisheries landing sites along the coast to demonstrate how combining community engagement and relatively low cost Global Positioning System (GPS) trackers can rapidly provide fine-scale information on: (1) the behavioral dynamics of the fishers and fleets that operate within this sector; and (2) the location, size and attributes of important fishing grounds upon which communities are dependent. This multi-disciplinary approach should be considered within a global context where uncertainty over the behavior of marine and terrestrial resource-users can lead to management decisions that potentially compromise local livelihoods, conservation, and resource sustainability goals.Publisher PDFPeer reviewe
The Lantern Vol. 39, No. 1, Fall 1972
• A Journey Into Darkness • September 5, 1972 • Atlantic Taperecorder • Aftermath • Linda • Sweet Baby Jane • The Court of the Ebony Clown • The Cosmic Band • Poem to the Dreamer • Dawn • Too Bad Life Isn\u27t • Incident at Tiffany\u27s • Sonnet • Infinitas • Podiatry • 2 and 4a • Autistic Autumn • I Walk Alone • Eyes---and They Were Emptyhttps://digitalcommons.ursinus.edu/lantern/1101/thumbnail.jp
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