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BACKGROUND: Chronic pain is a leading cause of disability worldwide. Fibromyalgia is a particularly debilitating form of widespread chronic pain. Fibromyalgia remains poorly understood, and treatment options are limited or moderately effective at best. Here, we present a protocol for a mechanistic study investigating the effects of psychedelic-assisted-therapy in a fibromyalgia population. The principal focus of this trial is the central mechanism(s) of psilocybin-therapy i.e., in the brain and on associated mental schemata, primarily captured by electroencephalography (EEG) recordings of the acute psychedelic state, plus pre and post Magnetic Resonance Imaging (MRI). METHODS: Twenty participants with fibromyalgia will complete 8 study visits over 8 weeks. This will include two dosing sessions where participants will receive psilocybin at least once, with doses varying up to 25mg. Our primary outcomes are 1) Lempel-Ziv complexity (LZc) recorded acutely using EEG, and the 2) the (Brief Experiential Avoidance Questionnaire (BEAQ) measured at baseline and primary endpoint. Secondary outcomes will aim to capture broad aspects of the pain experience and related features through neuroimaging, self-report measures, behavioural paradigms, and qualitative interviews. Pain Symptomatology will be measured using the Brief Pain Inventory Interference Subscale (BPI-IS), physical and mental health-related function will be measured using the 36-Item Short Form Health Survey (SF-36). Further neurobiological investigations will include functional MRI (fMRI) and diffusion tensor imaging (changes from baseline to primary endpoint), and acute changes in pre- vs post-acute spontaneous brain activity - plus event-related potential functional plasticity markers, captured via EEG. DISCUSSION: The results of this study will provide valuable insight into the brain mechanisms involved in the action of psilocybin-therapy for fibromyalgia with potential implications for the therapeutic action of

Within the context of scientific research, patient and public involvement (PPI) is defined as research performed "with" or "by" patients and members of the public, rather than "to," "about", or "for" them. When carried out systematically and thoughtfully, PPI has the potential to strengthen the quality and impact of research by fostering accountability, transparency, and relevance. There exist numerous guidelines, frameworks and tools for supporting PPI, however, these do not account for the unique challenges faced in psychedelic research. This paper describes the co-design of guidance intended to help build, evaluate and improve PPI in psychedelic research. A steering group was formed to design and run a co-design workshop alongside public collaborators. Insights from this workshop were analyzed and refined into a comprehensive and readily usable guide for planning PPI specific to the field of psychedelic research. Core values emerging from the process focused on the essential importance of trust, learning, purpose and inclusivity. It is hoped that this guidance will be a starting point for incorporating PPI in future psychedelic research, so that it can grow and adapt as this burgeoning field of research progresses.

Background Countries are adapting their health and social care systems to better meet the needs of growing populations with (multiple) chronic conditions. To guide this process, assessment of the ‘patient experience’ is becoming increasingly important. For this purpose, the Person-Centred Coordinated Care Experience Questionnaire (P3CEQ) was developed in the United Kingdom, and translated into several languages. Aim This study aimed to assess the internal and construct validity of the Dutch P3CEQ to capture the experience of person-centred coordinated care of people with chronic conditions in the Netherlands. Participants and Methods Adults with chronic conditions (N = 1098) completed the Dutch P3CEQ, measures of health literacy and patient activation, and reported the use and perceived quality of care services. Data analysis included Principal Component and reliability analysis (internal validity), analysis of variance and Student's T-tests (construct validity). Results The two-component structure found was pretty much the same as in the UK validation study. Sociodemographic correlates also resembled those found in the United Kingdom. Women, persons who were less educated, less health-literate or less activated experienced less person-centred coordinated care. P3CEQ scores correlated positively with general practitioner performance scores and quality ratings of the total care received. Conclusion The Dutch P3CEQ is a valid instrument to assess the experience of person-centred coordinated care among people with chronic conditions in the Netherlands. Awareness of inequity and more attention to communication skills in professional training are needed to ensure that care professionals better recognize the needs of women, lower educated or less health-literate persons, and improve their experiences of care. Patient Contribution The P3CEQ has been developed in collaboration with a range of stakeholders.

Background: Chronic Pain is among the leading causes of disability worldwide with up to 60% of patients suffering from comorbid depression. Psychedelic-assisted therapy has recently been found effective in treating a host of mental health issues including depression and has historically been found to be useful in treating pain. Reports of self-medication for chronic pain using psychedelic drugs have been widely documented, with anecdotal evidence indicating widespread success in a range of pathologies. Aims: In preparation for an upcoming trial, to better understand how those with lived experience of chronic pain self-medicate with psychedelic drugs, and to establish, in detail, their therapeutic protocols and practices for success. Methods: As part of patient-involvement (PI) for an upcoming trial in this population, 11 individuals who reported self-medicating with psychedelic drugs took part in a 1-h semi-structured discussion, which was then transcribed and thematically analyzed. Results: Across a range of psychedelic substances and doses, reported pain scores improved substantially during and after psychedelic experiences. Two processes, Positive Reframing and Somatic Presence, were reliably identified as playing a role in improvements in mental wellbeing, relationship with pain, and physical (dis)comfort. Inclusion of other strategies such as mindfulness, breathwork, and movement were also widely reported. Due to the data's subjective nature, this paper is vulnerable to bias and makes no claims on causality or generalisability. Together, these results have been used to inform study design for a forthcoming trial. Conclusion: This pre-trial PI work gives us confidence to test psychedelic therapy for chronic pain in a forthcoming controlled trial. The results presented here will be instrumental in improving our ability to meet the needs of future study participants.

Introduction: While several evaluation studies on (cost-)effectiveness of integrated care have been conducted in recent years, more insight is deemed necessary into integrated care from the perspective of service users. In the context of a European project on integrated care for older people living at home (SUSTAIN), this paper shares the experience and methodological reflections from applying a Patient Reported Experience Measure (PREM) on person-centred coordinated care -the P3CEQ- among this population. Methods: A combination of quantitative and qualitative data and analysis methods was used to assess the usability and the quality of applying a PREM among older people presenting complex care needs, using the P3CEQ delivery in SUSTAIN as a case study. 228 service users completed the P3CEQ and nine SUSTAIN researchers participated in a consultation about their experience administering the questionnaire. P3CEQ scores were analysed quantitatively using principal component analysis and multilevel linear regression. P3CEQ open responses and researcher notes collected when administering the questionnaire were thematically analysed. Results: Service user inclusion was high and most P3CEQ items had low non-response rates. Quantitative analysis and researcher experience indicate the relevance of face-to-face administration for obtaining such an amount of data in this population group. The presence of a carer increased inclusion of more vulnerable respondents, such as the cognitively impaired, but posed a challenge in data interpretation. Although several P3CEQ items were generally understood as intended by questionnaire developers, the analysis of open responses highlights how questions can lead to diverging and sometimes narrow interpretations by respondents. Cognitive impairment and a higher educational attainment were associated with lower levels of perceived person-centredness of care. Conclusion: his study shows essential pr

This thesis examines how stimulus similarity structure and the statistical properties of the environment influence human and nonhuman animal categorisation. Two aspects of categorisation behaviour are explored: unsupervised (spontaneous) categorisation and stimulus cross-classification. In my General Introduction, I raise the issue of the respective roles of similarity and the classifier in determining categorisation behaviour. In Chapter 1, I review previous laboratory-based unsupervised categorisation research, which shows an overwhelming bias for unsupervised classification based on a single feature. Given the prominent role of overall similarity (family resemblance) in theories of human conceptual structure, I argue that this bias for unidimensional classification is likely an artefact. One factor in producing this artefact, I suggest, are the biases that exist within the similarity structure of laboratory stimuli. Consequently, Chapter 2 examines if it is possible to predict unidimensional versus multidimensional classification based solely on abstract similarity structure. Results show that abstract similarity structure commands a strong influence over participants' unsupervised classification behaviour (although not always in the manner predicted), and a bias for multidimensional unsupervised classification is reported. In Chapter 3, I examine unsupervised categorisation more broadly, by investigating how stimulus similarity structure influences spontaneous classification in both humans and rats. In this way, evidence is sought for human-like spontaneous classification behaviour in rats. Results show that humans and rats show qualitatively different patterns of behaviour following incidental stimulus exposure that should encourage spontaneous classification. In Chapter 4,1 investigate whether rats exhibit another important aspect of human categorisation namely, stimulus cross-classification. Results show that the statistical properties of the environment can

This thesis examines how stimulus similarity structure and the statistical properties of the environment influence human and nonhuman animal categorisation. Two aspects of categorisation behaviour are explored: unsupervised (spontaneous) categorisation and stimulus cross-classification. In my General Introduction, I raise the issue of the respective roles of similarity and the classifier in determining categorisation behaviour. In Chapter 1, I review previous laboratory-based unsupervised categorisation research, which shows an overwhelming bias for unsupervised classification based on a single feature. Given the prominent role of overall similarity (family resemblance) in theories of human conceptual structure, I argue that this bias for unidimensional classification is likely an artefact. One factor in producing this artefact, I suggest, are the biases that exist within the similarity structure of laboratory stimuli. Consequently, Chapter 2 examines if it is possible to predict unidimensional versus multidimensional classification based solely on abstract similarity structure. Results show that abstract similarity structure commands a strong influence over participants' unsupervised classification behaviour (although not always in the manner predicted), and a bias for multidimensional unsupervised classification is reported. In Chapter 3, I examine unsupervised categorisation more broadly, by investigating how stimulus similarity structure influences spontaneous classification in both humans and rats. In this way, evidence is sought for human-like spontaneous classification behaviour in rats. Results show that humans and rats show qualitatively different patterns of behaviour following incidental stimulus exposure that should encourage spontaneous classification. In Chapter 4,1 investigate whether rats exhibit another important aspect of human categorisation namely, stimulus cross-classification. Results show that the statistical properties of the environment can

The events leading to the famous "Almanac Trial" began on the evening of Saturday, August 29, 185,7 during a religious camp meeting in Mason County. Willam "Duff" Armstron, James H. Norris and Grigsby Metzker were drinking on the outskirts of the meeting when a fight started and someone allegedly struck Metzker with a slung shot. Metzker died three days later. The state's attorney indicted Armstron and Norris in the Mason County Circuit Court for murder. Within one month the court tried, convicted, and sentenced Norris to eight years in the Alton Penitentiary. Norris later asked Lincoln to assist him in overturning the conviction. This collection of letters attests to Norris' character and asks the governor for clemency. Norris was pardoned August 10, 1863. Additional details may be found in: The Law Practice of Abraham Lincoln: Complete Documentary Edition. [Not all signers are listed in this record.]