Barriers to Treatment for Female Problem Gamblers: A UK Perspective

There is a paucity of research in the UK which examines problem gambling and that which does exist is mainly quantitative, focuses on male samples and fails to look at treatment seeking populations or obstacles preventing problem gamblers from seeking treatment. This paper presents findings from part of a larger qualitative study that explored the experience of treatment for female problem gamblers. Data were collected using semi-structured interviews with eight women who had received individual cognitive-behavioural therapy in the National Health Service for their gambling problem. An interpretative phenomenological analysis approach was applied in the research process, identifying three main themes, of which the subtheme ‘Barriers to Treatment’ is examined here. Internal and external barriers to treatment organically emerged in all female participants’ accounts and appear to have an impact on service utilisation. Input directly from gamblers can be combined with findings from other studies to devise better ways of reaching female problem gamblers. A better understanding of barriers to treatment can also provide valuable direction for future research and suggest applications in clinical service provision and treatment planning

A web-based intervention (RESTORE) to support self-management of cancer-related fatigue following primary cancer treatment: a multi-centre proof of concept randomised controlled trial

Purpose: Cancer-related fatigue (CRF) is a frequent and distressing symptom experienced after cancer treatment. RESTORE is the first web-based resource designed to enhance self-efficacy to manage CRF following curative-intent treatment. The aim of this study is to test the proof of concept and inform the design of an effectiveness trial. Methods: A multi-centre parallel-group two-armed (1:1) exploratory randomised controlled trial (RCT) with qualitative process evaluation was employed in the study. Participants (≥18 years; ≤5 years post treatment with moderate to severe fatigue) were recruited and randomly assigned to RESTORE or a leaflet. Feasibility and acceptability were measured by recruitment, attrition, intervention adherence, completion of outcome measures and process evaluation. Change in self-efficacy to manage CRF was also explored. Outcome measures were completed at baseline (T0), 6 weeks (T1) and 12 weeks (T2). Data were analysed using mixed-effects linear regression and directed content analysis. Results: One hundred and sixty-three people participated in the trial and 19 in the process evaluation. The intervention was feasible (39 % of eligible patients consented) and acceptable (attrition rate 36 %). There was evidence of higher fatigue self-efficacy at T1 in the intervention group vs comparator (mean difference 0.51 [−0.08 to 1.11]), though the difference in groups decreased by 12 weeks. Time since diagnosis influenced perceived usefulness of the intervention. Modifications were suggested. Conclusion: Proof of concept was achieved. The RESTORE intervention should be subject to a definitive trial with some adjustments. Provision of an effective supportive resource would empower cancer survivors to manage CRF after treatment completion

"A renewed sense of purpose": mothers' and fathers' experience of having a child following a recent stillbirth.

Most research has focused on mothers' experiences of perinatal loss itself or on the subsequent pregnancy, whereas little attention has been paid to both parents' experiences of having a child following late perinatal loss and the experience of parenting this child. The current study therefore explored mothers' and fathers' experiences of becoming a parent to a child born after a recent stillbirth, covering the period of the second pregnancy and up to two years after the birth of the next baby. In depth interviews were conducted with 7 couples (14 participants). Couples were eligible if they previously had a stillbirth (after 24 weeks of gestation) and subsequently had another child (their first live baby) who was now under the age of 2 years. Couples who had more than one child after experiencing a stillbirth and those who were not fluent in English were excluded. Qualitative analysis of the interview data was conducted using Interpretive Phenomenological Analysis. Five superordinate themes emerged from the data: Living with uncertainty; Coping with uncertainty; Relationship with the next child; The continuing grief process; Identity as a parent. Overall, fathers' experiences were similar to those of mothers', including high levels of anxiety and guilt during the subsequent pregnancy and after the child was born. Coping strategies to address these were identified. Differences between mothers and fathers regarding the grief process during the subsequent pregnancy and after their second child was born were identified. Despite difficulties with bonding during pregnancy and at the time when the baby was born, parents' perceptions of their relationship with their subsequent child were positive. Findings highlight the importance of tailoring support systems not only according to mothers' but also to fathers' needs. Parents', and particularly fathers', reported lack of opportunities for grieving as well as the high level of anxiety of both parents about their baby's wellbeing during pregnancy and after birth implies a need for structured support. Difficulties experienced in bonding with the subsequent child during pregnancy and once the child is born need to be normalised

A web-based intervention (RESTORE) to support self-management of cancer-related fatigue following primary cancer treatment: a multi-centre proof of concept randomised controlled trial

. A web-based intervention (RESTORE) to support self-management of cancer-related fatigue following primary cancer treatment: a multi-centre proof of concept randomised controlled trial. Supportive Care in Cancer, Results One hundred and sixty-three people participated in the trial and 19 in the process evaluation. The intervention was feasible (39 % of eligible patients consented) and acceptable (attrition rate 36 %). There was evidence of higher fatigue self-efficacy at T1 in the intervention group vs comparator (mean difference 0.51 [−0.08 to 1.11]), though the difference in groups decreased by 12 weeks. Time since diagnosis influenced perceived usefulness of the intervention. Modifications were suggested

Thallus heterogeneity of the cyanolichen Pseudocyphellaria crocata

A lichen is a symbiotic association between a fungus (the mycobiont) and one or more photosynthetic partners (the photobiont) which may be a green alga, a cyanobacterium (blue-green algae) or both a green alga and a cyanobacterium. This is a complex association where the fungus produces a thallus distinct from its free- living form, and this thallus “houses” the photobiont. Pseudocyphellaria crocata is a cyanolichen, with the cyanobacterium Nostoc providing both photosynthate and fixed nitrogen to the fungal partner. Based upon previous data collected from other Nostoc symbioses, a proposed symbiotic association model was created by Rai et al. (2000). This model suggests that there are some substantial structural and functional changes between differing parts of the symbiotic tissue, i.e. the further from the growing margin the cyanobacterium are, the higher the level of heterocyst frequency and nitrogen fixation. The aims of this project were to both (i) look at the differing patterns of gene expression for the photobiont across different areas of the thallus, and (ii) to examine any physiological changes in intrathalline heterogeneity. The main results demonstrate that there are key differences in both gene expression and the physiological measurements that are involved in cell specific functions in the continuous cyanobacterial layer across the thallus, suggesting some form of thallus heterogeneity in Pseudocyphellaria crocata. The gene expression data showed an increase in nitrogen fixation and heterocyst frequency in the thallus centre and conversely an increase in the photosynthetic capability in the growing margins, as is also seen in the proposed symbiotic association model. Whereas the physiological measurements, being chlorophyll fluorescence and oxygen evolution, were too highly variable and were therefore too difficult to draw any solid conclusions from. However, between the two data sets, the overall results imply that there is some form of thallus heterogeneity occurring in Pseudocyphellaria crocata. Further research is needed to provide insight into the communication and co-ordinated growth of the respective symbionts, in order to gain a deeper understanding of this symbiosis

Thallus heterogeneity of the cyanolichen Pseudocyphellaria crocata

A lichen is a symbiotic association between a fungus (the mycobiont) and one or more photosynthetic partners (the photobiont) which may be a green alga, a cyanobacterium (blue-green algae) or both a green alga and a cyanobacterium. This is a complex association where the fungus produces a thallus distinct from its free- living form, and this thallus “houses” the photobiont. Pseudocyphellaria crocata is a cyanolichen, with the cyanobacterium Nostoc providing both photosynthate and fixed nitrogen to the fungal partner. Based upon previous data collected from other Nostoc symbioses, a proposed symbiotic association model was created by Rai et al. (2000). This model suggests that there are some substantial structural and functional changes between differing parts of the symbiotic tissue, i.e. the further from the growing margin the cyanobacterium are, the higher the level of heterocyst frequency and nitrogen fixation. The aims of this project were to both (i) look at the differing patterns of gene expression for the photobiont across different areas of the thallus, and (ii) to examine any physiological changes in intrathalline heterogeneity. The main results demonstrate that there are key differences in both gene expression and the physiological measurements that are involved in cell specific functions in the continuous cyanobacterial layer across the thallus, suggesting some form of thallus heterogeneity in Pseudocyphellaria crocata. The gene expression data showed an increase in nitrogen fixation and heterocyst frequency in the thallus centre and conversely an increase in the photosynthetic capability in the growing margins, as is also seen in the proposed symbiotic association model. Whereas the physiological measurements, being chlorophyll fluorescence and oxygen evolution, were too highly variable and were therefore too difficult to draw any solid conclusions from. However, between the two data sets, the overall results imply that there is some form of thallus heterogeneity occurring in Pseudocyphellaria crocata. Further research is needed to provide insight into the communication and co-ordinated growth of the respective symbionts, in order to gain a deeper understanding of this symbiosis

Understanding protoplast technology as a tool to enhance biocontrol : A thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy at Lincoln University

Biocontrol of plant pathogens is an integral part of modern pest and disease management. Issues of pesticide residues/resistance and a drive towards sustainability within crop protection systems have created an opportunity for sustainable alternatives to synthetic agro-chemicals. One approach within integrated pest management programmes is the use of biocontrol agents, such as fungi. The development of novel biocontrol strains using protoplast technology provides the opportunity to re-combine or introduce desired features, in particular fungicide tolerance, without the need for sexual reproduction. This present study employed protoplast regeneration to produce novel Trichoderma strains with attributes such as pesticide tolerance for the control of the bacterium causing kiwifruit canker, Pseudomonas syringae pv. actinidae (Psa). To achieve this, leading Trichoderma strains were selected from within current research programmes targeted at kiwifruit health. Using protoplast regeneration, numerous strains were produced that were tolerant separately to copper sulphate and Chief® (a.i. carbendazim). Further bioactivity trials showed that biocontrol potential of the protoplast progeny was not reduced as a consequence of this strain enhancement. However, despite the use of fungal protoplast technology for strain improvement very little is known of the underlying genetic changes responsible for the modified phenotypes. The overall hypothesis was that cytosine methylation may be responsible for the phenotypic plasticity that was observed in these protoplast progeny, with this study being the first to examine the consequences of protoplast regeneration through a multi-layered, integrative ‘omics approach. The differential cytosine mapping through whole genome bisulphite sequencing showed sparse differential methylation between a protoplast regenerant (copper tolerant FCC237/R5 T. sp. “atroviride B”) and its parent (FCC237 T. sp. “atroviride B”). This cytosine methylation did not appear to modulate corresponding gene expression levels to differentially methylated associated genes, as it had been reported in other fungal species. The transcriptome analysis indicated differential gene expression between the parent and regenerant in both sub-lethal levels of copper sulphate (1 mM) (88 DEGs) and also in the control PDB (281 DEGs). The changes in DEGs profiles, especially regarding proteins involved in oxidative stress, secondary metabolites and transporters could suggest that the regenerant may induce a general stress response as opposed to a specific pathway for copper tolerance that has arisen as a putative result of protoplast regeneration. Other epigenetic factors, including histone and chromatin modifications and RNA interference, are likely to play an important in both regulating gene expression states and the phenotypic plasticity observed in the protoplast regenerant. Although other epigenetic modifications have not been tested here, they would be expected to be present due to the interconnectedness of the epigenome and further elucidation is required. This work has contributed to a better understanding of the basic genetic events that occur during protoplasting in Trichoderma, which may allow for greater advances in not only strain enhancement, but also in genetic modification experiments, in both Trichoderma but other filamentous fungi

Can Resistance Exercise Be a Tool for Healthy Aging in Post-Menopausal Women with Type 1 Diabetes?

Due to improvements in diabetes care, people with type 1 diabetes (T1D) are living longer. Studies show that post-menopausal T1D women have a substantially elevated cardiovascular risk compared to those without T1D. As T1D may also accelerate age-related bone and muscle loss, the risk of frailty may be considerable for T1D women. Exercise and physical activity may be optimal preventative therapies to maintain health and prevent complications in this population: They are associated with improvements in, or maintenance of, cardiovascular health, bone mineral density, and muscle mass in older adults. Resistance exercise, in particular, may provide important protection against age-related frailty, due to its specific effects on bone and muscle. Fear of hypoglycemia can be a barrier to exercise in those with T1D, and resistance exercise may cause less hypoglycemia than aerobic exercise. There are currently no exercise studies involving older, post-menopausal women with T1D. As such, it is unknown whether current guidelines for insulin adjustment/carbohydrate intake for activity are appropriate for this population. This review focuses on existing knowledge about exercise in older adults and considers potential future directions around resistance exercise as a therapeutic intervention for post-menopausal T1D women