Living with unpredictability in Multiple Sclerosis

Background: Unpredictability is identified as a major factor in Multiple Sclerosis (MS) and reported to be a “constant companion” for individuals living with MS. It is reported to be a factor of uncertainty, which is indicated to have a biopsychosocial impact on these individuals. However the impact of uncertainty is argued to diminish over time. Whereas, the lived experience of unpredictability is reported to be continual. Furthermore, unpredictability is argued to have a continual psychological effect on individuals with MS. However, unpredictability is an aspect that remains relatively unaddressed in the research. Qualitative research has been highlighted to be fundamental in exploring the individual experience of illness, providing rich detailed descriptions. In addition it has been instrumental in the development of services to meet the needs of these individuals. The significance of unpredictability in MS highlights the need for further exploration of lived experience of this aspect of the illness to support healthcare professionals and the development of services to meet the needs of these individuals. Aim: This study aimed to address the limited research examining unpredictability in MS, to develop a comprehensive understanding of how this aspect affects the lives of individuals with MS. Method: This study employed a qualitative design. Twelve participants were recruited through the MS Society, local advertisements and by a ‘snowballing’ sampling technique. All participants lived in England, had a diagnosis of MS, and were able to provide consent to participate. Individual interviews were conducted (7 face-to-face and 5 telephone interviews) using a semi-structured interview. Interviews were transcribed verbatim and analysed by the researcher using a thematic analysis (TA) approach. Results: Three main themes were derived from the analysis: 1) Challenges to meaning-making; 2) A wide picture of unpredictability; and 3) Surviving unpredictability. Each of the themes generated between two or three sub-themes. The themes told the participant’s story for living with unpredictability. Conclusion and recommendations: Unpredictability was reported to be a key factor of living with MS, yet it was challenging and difficult to understand. Participants described the wide reaching impact of unpredictability influencing them personally and socially. Pragmatic and psychological approaches were employed by participants to deal with unpredictability. The findings offer insight into the individual’s experience of living with unpredictability. It is argued the findings represent individuals who have reached a stage of acceptance with their illness and therefore may offer health professionals guidance around how to support individuals who have not been able to come to terms with the unpredictability of their illness. Furthermore, the findings highlight the wide reaching impact of unpredictability emphasising the importance of the family team. These findings may offer health professionals guidance around providing family education and support to help develop a cohesive network of support for the individual and the family experiencing the effects of unpredictability in MS

The metabolic and molecular mechanisms of hyperammonaemia and hyperethanolaemia induced protein catabolism in skeletal muscle cells

Hyperammonaemia and hyperethanolaemia are thought to be driving factors behind skeletal muscle myopathy in liver disease i.e. cirrhosis. Despite this, the singular and combined impacts of ethanol and ammonia induced protein catabolism are poorly defined. As such, we aimed to dissect out the effects of ammonia and ethanol on muscle catabolism. Murine C2C12 myotubes were treated with ammonium acetate (10 mM) and ethanol (100 mM) either alone or in combination for 4h and/or 24h. Myotube diameter, muscle protein synthesis and anabolic and catabolic signalling pathways were assessed. In separate experiments, cells were co-treated with selected inhibitors of protein breakdown to assess the importance of proteolytic pathways in protein loss with ammonia and ethanol. Ammonia and ethanol in combination resulted in a reduction in myotube width and total protein content, that was greater than the reduction observed with ammonia alone. Both ammonia and ethanol caused reductions in protein synthesis, as assessed by puromycin incorporation. There was also evidence of impairments in regulation of protein translation, and increased protein expression of markers of muscle protein breakdown. Myotube protein loss with ammonia plus ethanol was not affected by autophagy inhibition, but was completely prevented by proteasome inhibition. Thus, combined ammonia and ethanol incubation of C2C12 myotubes exacerbated myotube atrophy and dysregulation of anabolic and catabolic signalling pathways associated with either component individually. Ubiquitin proteasome-mediated protein breakdown appears to play an important role in myotube protein loss with ethanol and ammonia

Animals can assign novel odours to a known category

The ability to identify a novel stimulus as a member of a known category allows an organism torespond appropriately towards it. Categorisation is thus a fundamental component of cognition andan essential tool for processing and responding to unknown stimuli. Therefore, one might expectto observe it throughout the animal kingdom and across sensory domains. There is much evidenceof visual categorisation in non-human animals, but we currently know little about this process inother modalities. In this experiment, we investigated categorisation in the olfactory domain. Dogswere trained to discriminate between 40 odours; the presence or absence of accelerants formed thecategorical rule. Those in the experimental group were rewarded for responding to substrates withaccelerants (either burnt or un-burnt) and inhibit responses to the same substrates (either burnt or unburnt)without accelerants (S+ counterbalanced). The pseudocategory control group was trained onthe same stimuli without the categorical rule. The experimental group learned the discrimination andanimals were able to generalise to novel stimuli from the same category. None of the control animalswere able to learn the discrimination within the maximum number of trials. This study provides the firstevidence that non-human animals can learn to categorise non-biologically relevant odour information

Living Under Coronavirus and Injecting Drugs in Bristol (LUCID-B): a qualitative study of experiences of COVID-19 among people who inject drugs

BACKGROUND: : People who inject drugs (PWID) are a high-risk group for COVID-19 transmission and serious health consequences. Restrictions imposed in the UK in response to the pandemic led to rapid health and housing service alterations. We aimed to examine PWID experiences of: 1) challenges relating to the COVID-19 public health measures; 2) changes to opioid substitution therapy (OST) and harm reduction services; and 3) perceived effects of COVID-19 on drug use patterns and risk behaviour. METHODS: : Telephone semi-structured interviews were conducted with 28 PWID in Bristol, Southwest of England. Analysis followed a reflexive thematic analysis. RESULTS: : Concern about COVID-19 and adherence to public health guidance varied. Efforts made by services to continue providing support during the pandemic were appreciated and some changes were preferred, such as less frequent OST collection, relaxation of supervised consumption and needle and syringe programmes (NSP) home delivery. However, remote forms of contact were highlighted as less beneficial and more difficult to engage with than in-person contact. Public health guidance advising people to ‘stay home’ led to increased isolation, boredom, and time to ruminate which impacted negatively on mental health. Lockdown restrictions directly impacted on sources of income and routine. Changes in drug use were explained as a consequence of isolation and fewer interactions with peers, problems accessing drugs, reduced drug purity and reduced financial resources. CONCLUSION: : This study captures the significant impacts and challenges of the COVID-19 pandemic on the lives of PWID. While rapid adaptations to service delivery to help mitigate the risks of COVID-19 were appreciated and some changes such as relaxation of supervised daily OST consumption were viewed positively, barriers to access need further attention. Going forwards there may be opportunities to harness the positive aspects of some changes to services

Genetic information: important but not "exceptional"

Much legislation dealing with the uses of genetic information could be criticised for exceptionalising genetic information over other types of information personal to the individual. This paper contends that genetic exceptionalism clouds the issues, and precludes any real debate about the appropriate uses of genetic information. An alternative to “genetically exceptionalist” legislation is to “legislate for fairness”. This paper explores the “legislating for fairness” approach, and concludes that it demonstrates a fundamental misunderstanding of both how legislation is drafted, and how it is interpreted. The uncomfortable conclusion is this: policy-makers and legislators must tackle head-on the difficult policy questions concerning what should and should not be done with genetic information. Only by confronting this crucial issue will they achieve a workable legislative solution to the problems caused by genetic information

DNA barcoding the native flowering plants and conifers of Wales

We present the first national DNA barcode resource that covers the native flowering plants and conifers for the nation of Wales (1143 species). Using the plant DNA barcode markers rbcL and matK, we have assembled 97.7% coverage for rbcL, 90.2% for matK, and a dual-locus barcode for 89.7% of the native Welsh flora. We have sampled multiple individuals for each species, resulting in 3304 rbcL and 2419 matK sequences. The majority of our samples (85%) are from DNA extracted from herbarium specimens. Recoverability of DNA barcodes is lower using herbarium specimens, compared to freshly collected material, mostly due to lower amplification success, but this is balanced by the increased efficiency of sampling species that have already been collected, identified, and verified by taxonomic experts. The effectiveness of the DNA barcodes for identification (level of discrimination) is assessed using four approaches: the presence of a barcode gap (using pairwise and multiple alignments), formation of monophyletic groups using Neighbour-Joining trees, and sequence similarity in BLASTn searches. These approaches yield similar results, providing relative discrimination levels of 69.4 to 74.9% of all species and 98.6 to 99.8% of genera using both markers. Species discrimination can be further improved using spatially explicit sampling. Mean species discrimination using barcode gap analysis (with a multiple alignment) is 81.6% within 10×10 km squares and 93.3% for 2×2 km squares. Our database of DNA barcodes for Welsh native flowering plants and conifers represents the most complete coverage of any national flora, and offers a valuable platform for a wide range of applications that require accurate species identification

How Do Executive Functions Influence Children’s Reasoning About Counterintuitive Concepts in Mathematics and Science?

Many scientific and mathematical concepts are counterintuitive because they conflict with misleading perceptual cues or incorrect naive theories that we build from our everyday experiences of the world. Executive functions (EFs) influence mathematics and science achievement, and inhibitory control (IC), in particular, might facilitate counterintuitive reasoning. Stop & Think (S&T) is a computerised learning activity that trains IC skills. It has been found effective in improving primary children’s mathematics and science academic performance in a large scale RCT trial (Palak et al., 2019; Wilkinson et al., Journal of Cognitive Enhancement, 4, 296–314, 2020). The current study aimed to investigate the role of EFs and the moderating effects of S&T training on counterintuitive mathematics and science reasoning. A sample of 372 children in school Years 3 (7- to 8-year-olds) and 5 (9- to 10-year-olds) were allocated to S&T, active control or teaching as usual conditions, and completed tasks assessing verbal and visuospatial working memory (WM), IC, IQ, and counterintuitive reasoning, before and after training. Cross-sectional associations between counterintuitive reasoning and EF were found in Year 5 children, with evidence of a specific role of verbal WM. The intervention benefited counterintuitive reasoning in Year 3 children only and EF measures were not found to predict which children would most benefit from the intervention. Combined with previous research, these results suggest that individual differences in EF play a lesser role in counterintuitive reasoning in younger children, while older children show a greater association between EFs and counterintuitive reasoning and are able to apply the strategies developed during the S&T training to mathematics and science subjects. This work contributes to understanding why specifically the S&T intervention is effective. This work was preregistered with the ISRCTN registry (TRN: 54726482) on 10/10/2017

Antisocial behaviour and teacher–student relationship quality: The role of emotion‐related abilities and callous–unemotional traits

Background: Childhood antisocial behaviour has been associated with poorer teacher-student relationship (TSR) quality. It is also well-established that youth with antisocial behaviour have a range of emotion-related deficits, yet the impact of these students’ emotion-related abilities on the TSR is not understood. Furthermore, the addition of the Limited Prosocial Emotions specifier in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) indicates that understanding the role of callous-unemotional (CU) traits for youth with antisocial behaviour problems is of particular importance. Aims: The aim of this study was to investigate the association between antisocial behaviour difficulties and the TSR by examining the influence of emotion-related abilities and CU traits. Sample: Twelve teachers from 10 primary schools provided anonymised information on 108 children aged 6-11 years. Results: Antisocial behaviour was associated with higher teacher-student conflict (but not closeness) as well as higher emotion lability/negativity and lower emotion understanding/empathy. Emotion lability/negativity was associated with higher teacher-student conflict (but not closeness), and emotion understanding/empathy was associated with lower teacher-student conflict and higher closeness. CU traits was associated with higher teacher-student conflict and lower teacher-student closeness (controlling for antisocial behaviour more broadly). We found no evidence of a moderating effect of CU traits or emotion-related abilities on the association between antisocial behaviour and TSR quality. Conclusions: Interventions for behaviour difficulties should consider teacher-student relationships in the classroom. Strategies which aim to improve teacher-student closeness as well as reduce teacher-student conflict may be of particular value to students with high CU traits