Search

Background Physical activity can support smoking cessation for smokers wanting to quit, but there have been no studies on supporting smokers wanting only to reduce. More broadly, the effect of motivational support for such smokers is unclear. Objectives The objectives were to determine if motivational support to increase physical activity and reduce smoking for smokers not wanting to immediately quit helps reduce smoking and increase abstinence and physical activity, and to determine if this intervention is cost-effective. Design This was a multicentred, two-arm, parallel-group, randomised (1 : 1) controlled superiority trial with accompanying trial-based and model-based economic evaluations, and a process evaluation. Setting and participants Participants from health and other community settings in four English cities received either the intervention (n = 457) or usual support (n = 458). Intervention The intervention consisted of up to eight face-to-face or telephone behavioural support sessions to reduce smoking and increase physical activity. Main outcome measures The main outcome measures were carbon monoxide-verified 6- and 12-month floating prolonged abstinence (primary outcome), self-reported number of cigarettes smoked per day, number of quit attempts and carbon monoxide-verified abstinence at 3 and 9 months. Furthermore, self-reported (3 and 9 months) and accelerometer-recorded (3 months) physical activity data were gathered. Process items, intervention costs and cost-effectiveness were also assessed. Results The average age of the sample was 49.8 years, and participants were predominantly from areas with socioeconomic deprivation and were moderately heavy smokers. The intervention was delivered with good fidelity. Few participants achieved carbon monoxide-verified 6-month prolonged abstinence [nine (2.0%) in the intervention group and four (0.9%) in the control group; adjusted odds ratio 2.30 (95% confidence interval 0.70 to 7.56)] or 12-month prolonged abstinence [six (1.3%) in the intervention group and one (0.2%) in the control group; adjusted odds ratio 6.33 (95% confidence interval 0.76 to 53.10)]. At 3 months, the intervention participants smoked fewer cigarettes than the control participants (21.1 vs. 26.8 per day). Intervention participants were more likely to reduce cigarettes by ≥ 50% by 3 months [18.9% vs. 10.5%; adjusted odds ratio 1.98 (95% confidence interval 1.35 to 2.90] and 9 months [14.4% vs. 10.0%; adjusted odds ratio 1.52 (95% confidence interval 1.01 to 2.29)], and reported more moderate-to-vigorous physical activity at 3 months [adjusted weekly mean difference of 81.61 minutes (95% confidence interval 28.75 to 134.47 minutes)], but not at 9 months. Increased physical activity did not mediate intervention effects on smoking. The intervention positively influenced most smoking and physical activity beliefs, with some intervention effects mediating changes in smoking and physical activity outcomes. The average intervention cost was estimated to be £239.18 per person, with an overall additional cost of £173.50 (95% confidence interval −£353.82 to £513.77) when considering intervention and health-care costs. The 1.1% absolute between-group difference in carbon monoxide-verified 6-month prolonged abstinence provided a small gain in lifetime quality-adjusted life-years (0.006), and a minimal saving in lifetime health-care costs (net saving £236). Conclusions There was no evidence that behavioural support for smoking reduction and increased physical activity led to meaningful increases in prolonged abstinence among smokers with no immediate plans to quit smoking. The intervention is not cost-effective. Limitations Prolonged abstinence rates were much lower than expected, meaning that the trial was underpowered to provide confidence that the intervention doubled prolonged abstinence. Future work Further research should explore the effects of the present intervention to support smokers who want to reduce prior to quitting, and/or extend the support available for prolonged reduction and abstinence. Trial registration This trial is registered as ISRCTN47776579. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 27, No. 4. See the NIHR Journals Library website for further project information.

Individuals with posttraumatic stress disorder (PTSD) are at an increased risk of being classified as overweight or with obesity in part due to PTSD symptoms (e.g., sleep disturbance and social isolation) interfering with activity and healthy eating. MOVE!+UP is a 16-week behavioral weight management program, tailored to address such barriers for people with PTSD, by combining evidence-based weight loss education and support with cognitive behavior therapy skills to reduce PTSD symptom-based weight management barriers. This qualitative study examined veterans' (n = 37) perceptions of social support relevant to weight management, health behaviors, and mental health while participating in an uncontrolled pilot of MOVE!+UP. Template analysis of transcripts from 1-hr semistructured qualitative interviews identified four main categories of participant responses. Participants described positive aspects, particularly cohesiveness around a shared veteran identity, feeling less alone, accountability, and having others eat healthier and exercise with them. Conversely, relationship-based barriers included other participants' poor MOVE!+UP group session attendance and engagement, and loved ones' encouragement of making unhealthy choices. Many described having limited relationships or trouble accessing available support. Finally, PTSD symptoms were a significant barrier to utilizing social support to facilitate weight loss. Findings suggest future behavioral weight management programs should recruit members with similar backgrounds to capitalize on shared experience, encourage consistent attendance and meaningful participation, deliver education about how to leverage social support from others outside the program, and address mental health symptoms that impede social support and healthy lifestyles. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Posttraumatic stress disorder (PTSD) is associated with high comorbidity rates across the full range of psychiatric disorders. However, little is known about how psychiatric comorbidity manifests among people with PTSD, particularly with regard to concurrent diagnoses.Latent class analysis (LCA) was used to characterize discrete classes of PTSD comorbidity using past year DSM-5 diagnostic standards among a large nationally representative epidemiologic sample of U.S. adults. Follow-up analyses compared participant characteristics across latent classes.The LCA was best characterized by five classes: low comorbidity, distress-fear, distress-externalizing, mania-fear-externalizing, and mania-externalizing. Excluding the low comorbidity class, proportions of borderline and schizotypal personality disorder were high across classes.Participant characteristics across classes of past year PTSD comorbidity are explored through the lens of case conceptualization and treatment planning utility.

For means of communication, persuasion is a natural and critical part of conveying a message. Data visualizations, being means of communication themselves, are used as rhetorical instruments, but how they persuade has yet to be fully understood. Based on George Campbell’s rhetorical theory, this paper presents the results of an empirical study testing the effectiveness of appeals to emotion through proximity techniques – the contextual framing of a visualization. The findings indicate that people feel greater interest towards a topic when the visualized data are more relevant to them, and that data representing events closer in time are more affecting.

BackgroundParkinson’s disease has been identified as a risk factor for severe Coronavirus disease 2019 (COVID-19) outcomes. However, whether the significant high risk of death from COVID-19 in people with Parkinson’s disease is specific to the disease itself or driven by other concomitant and known risk factors such as comorbidities, age, and frailty remains unclear.ObjectiveTo investigate clinical profiles and outcomes of people with Parkinson’s disease and atypical parkinsonian syndromes who tested positive for COVID-19 in the hospital setting in a multicentre UK-based study.MethodsA retrospective cohort study of Parkinson’s disease patients with a positive COVID-19 test admitted to hospital between February 2020 and July 2021. An online survey was used to collect data from clinical care records, recording patient, Parkinson’s disease and COVID-19 characteristics. Associations with time-to-mortality and severe outcomes were analysed using either the Cox proportional hazards model or logistic regression models, as appropriate.ResultsData from 552 admissions were collected: 365 (66%) male; median (inter-quartile range) age 80 (74-85) years. The 34-day mortality rate was 38.4%; male sex, increased age and frailty, Parkinson’s dementia syndrome, requirement for respiratory support and no vaccination were associated with increased mortality risk. Community-acquired COVID-19 and co-morbid chronic neurological disorder were associated with increased odds of requiring respiratory support. Hospital-acquired COVID-19 and delirium were associated with requiring an increase in care level post-discharge.ConclusionsThis first, multicentre, UK-based study on people with Parkinson’s disease or atypical parkinsonian syndromes, hospitalised with COVID-19, adds and expands previous findings on clinical profiles and outcomes in this population.

Background The efficacy of a single administration of darvadstrocel (expanded allogeneic adipose-derived mesenchymal stem cells) for treating complex perianal fistulas in patients with Crohn’s disease was demonstrated in a randomized, double-blind trial (ADMIRE-CD [Adipose Derived Mesenchymal Stem Cells for Induction of Remission in Perianal Fistulizing Crohn\'s Disease] trial). The current chart review study (INSPECT [A retrospectIve chart review study evaluatINg the longer-term effectiveneSs of darvadstrocel in PatiEnts who CompleTed ADMIRE-CD]) evaluated the longer-term effectiveness and safety of darvadstrocel. Methods Eligible patients had completed at least 52 weeks in the ADMIRE-CD trial. Data on clinical remission and fistula relapse outcomes were collected retrospectively at 104 and 156 weeks after treatment. Adverse events of special interest (tumorigenicity and ectopic tissue formation) were collected up to 208 weeks after treatment. Results Eighty-nine patients were included (43 darvadstrocel patients, 46 control subjects). At 52, 104, and 156 weeks posttreatment, clinical remission was observed in 29 (67.4%) of 43, 23 (53.5%) of 43, and 23 (53.5%) of 43 darvadstrocel-treated patients, compared with 24 (52.2%) of 46, 20 (43.5%) of 46, and 21 (45.7%) of 46 control subjects, respectively. In patients with clinical remission at week 52, this remission was sustained at 104 and 156 weeks after treatment in 19 (65.5%) of 29 and 16 (55.2%) of 29 darvadstrocel-treated patients and in 17 (70.8%) of 24 and 13 (54.2%) of 24 control subjects, respectively. Time to fistula relapse and incidence of fistula relapse or new fistula occurrence were not significantly different between groups. Tumorigenicity was reported for 1 (2.2%) patient in the control group (malignant epidermoid carcinoma). No ectopic tissue formation was reported. Conclusions Real-world follow-up of patients from the ADMIRE-CD trial indicates that clinical remission of complex perianal fistulas can be sustained in the long term irrespective of whether it is achieved through darvadstrocel administration or maintenance treatment regimens and confirms a favorable long-term safety profile of darvadstrocel.

Objective The purpose of this study was to collect pilot efficacy data on a novel treatment for refractory chronic cough (RCC), which we call cough desensitization treatment (CDT). Design and methods In this parallel cohort, sham-controlled, randomized controlled trial, 21 adults with RCC were randomly assigned to 12 sessions of either CDT (progressive doses of aerosolized capsaicin while behaviorally suppressing cough; n = 11) or a sham treatment (repeated exposure to aerosolized saline; n = 9). The Leicester Cough Questionnaire (LCQ) was the primary outcome measure. Perceived cough severity with a visual analogue scale and cough challenge testing (for measuring cough-reflex sensitivity) were secondary outcome measures. Data were analyzed with mixed effects linear regression and follow-up contrasts. Results Results on all measures favored CDT. Excluding one sham participant, whose baseline LCQ scores were deemed unreliable, mean change in LCQ at 3-weeks post treatment was 6.35 and 2.17 in the CDT and sham groups, respectively. There was moderate to strong evidence of a greater improvement in the CDT group in total LCQ score (p = .058) and LCQ Psychological domain (p = .026) and Physical domain (p = .045) scores. Strong evidence was found for a greater reduction in urge-to-cough during CCT in the CDT group (p = .037) and marginal for a reduction in the capsaicin cough-reflex sensitivity (p = .094). There was weak evidence of a greater reduction in cough severity in the CDT group (p = .103). Discussion Although the study is limited due to the small sample size, the data provide additional evidence supporting further research on CDT. CDT resulted in a greater change in the primary efficacy measure (LCQ) than both pharmaceutical and behavioral treatments currently found in the literature. Trial Registration This trial (NCT05226299) was registered on Clinicaltrials.gov on 07/02/2022.

Aims The aim of this survey is to analyze how current recommendations on valvular heart disease (VHD) management have been adopted. Identifying potential discrepancies between recommendations and everyday clinical practice would enable us to better understand and address the remaining challenges in this controversial and complex field. Methods and results A total of 33 questions, distributed via email to all European Society of Cardiology (ESC) affiliated countries through the newsletter of the ESC council on VHD, were answered by 689 respondents, mainly from tertiary care settings. The results of this survey showed that VHD patients are mostly managed by tertiary care centres, where multi-disciplinary heart teams are frequently a reality. Cardiac computed tomography (CT) is often used in the preprocedural planning of transcatheter interventions, particularly for sizing and deliverability assessment. Echocardiography represents the most widely used imaging modality in the diagnostic, intra-operative and follow-up phase of VHD patients. Cardiac magnetic resonance (CMR) is still largely underused, also for conditions such as mitral annular disjunction, or for the assessment of left ventricle volumes where it is considered as the gold standard, despite 3D volumes by echocardiography having proved good comparability with CMR. As for endocarditis, despite still underused, transesophageal echocardiography (TEE) represents the approach of choice for the diagnosis of native and prosthesis valve endocarditis (up to 46% of the respondents use it). In this context, positron emission tomography-CT is largely underused. Conclusion There is widespread adoption of current recommendation on the evaluation of VHD and these are frequently used to guide patient management. Nonetheless, there are still many discrepancies across centres and countries which need to be addressed with the aim of improving patients’ management and outcomes and ultimately positively impacting on healthcare resources.

Background A Functional Medicine program was developed at an inflammatory bowel disease (IBD) center with the goal of integrating strategies to address modifiable lifestyle factors and to complete a 6-week elimination diet under the direction of a trained Functional Medicine dietitian and Functional Medicine providers. Methods From January 2019 to November 2019, patients with controlled, but persistent, symptoms from IBD were offered enrollment. Each of the 5 visits incorporated an educational session focused on nutrition followed by a session focusing on modifiable lifestyle factors. The patients were placed on a supervised 6-week elimination diet. At each visit, patients completed the SIBDQ (Short Inflammatory Bowel Disease Questionnaire), FSS (Fatigue Severity Scale), PSQI (The Pittsburgh Sleep Quality Index), and MSQ (Medical Symptoms Questionnaire). Statistical analysis was performed using the Wilcoxon matched pairs signed-rank test. Results Nineteen patients enrolled (2 men: 1 ulcerative colitis [UC], 1 Crohn’s disease [CD]; 17 women: 3 UC, 14 CD). 15 patients completed all modules. There was improvement in all patient-reported outcomes (PROs) (FSS, P < .001; PSQI, P < .001; SIBDQ, P < .001; MSQ, P < .001). Every patient who completed the last session demonstrated weight loss. Conclusions The psychoemotional roots to immune disease states, particularly IBD, are complicated and often not addressed in traditional care. We are just beginning to understand the impact of nutrition, sleep, stress, movement, and relationships on IBD. In this cohort, utilizing Functional Medicine as an adjunct to traditional care resulted in improvement in all PROs.

Children who have been maltreated are at an increased risk of having their pain under-recognized and undertreated by healthcare professionals, and thus, are more susceptible to adverse outcomes associated with undertreated pain. This study’s aims were to examine: ( 1) if healthcare professionals’ pediatric pain knowledge is associated with their pain assessment methods, ( 2) if maltreatment-specific pain knowledge is associated with consideration of child maltreatment when deciding on a pain management strategy, and ( 3) if pediatric pain knowledge would relate to maltreatment-specific pain knowledge. A sample ( N = 108) of healthcare professionals responded to a survey designed to examine their current knowledge and utilization of pediatric pain assessment and management with emphasis on the effects of child maltreatment. Findings revealed healthcare professionals’ knowledge of pediatric pain is independent of their pain assessment and management practices. However, general pain knowledge was associated with maltreatment-specific pain knowledge and generally, healthcare professionals were knowledgeable of child maltreatment’s impact on pediatric pain. Participants who considered a history of maltreatment were also more likely to employ sensitive questioning strategies when asking children about their pain.

On November 6, 2020 , researchers who have been laboring to find a drug that will treat Alzheimer’s disease (AD) dialed in to a public meeting of the U.S. Food and Drug Administration’s (FDA) Peripheral and Central Nervous System Drugs Advisory Committee. The committee would review drug trials of Biogen’s aducanumab, and conclude with a vote on the drug’s safety and efficacy in treating AD. The independent advisors’ decision wouldn’t be the official one for aducanumab, but their vote usually mirrors the final FDA decision.

The provision and receipt of emotional support demonstrates benefits for relationships; however, little research has investigated how either global or day-to-day spousal support influences marital stability. This project assessed how global perception of support from a partner and daily provision and receipt of emotional support over 1 week contributed to divorce 10 years later, accounting for demographic covariates. There were no significant associations of support variables with future divorce. Greater education attainment was the only factor significantly associated with decreased risk for divorce. Results suggest that despite potential short-term benefits, global and daily support may not predict long-term marital stability.

Statistics should be “the driest of all reading”, according to a quote often attributed to the Victorian statistician William Farr. But Michael Schuckers and Sarah Campbell beg to differ. Here, they explain why narratives are key to capturing reader attention

This article draws upon six social research studies completed by members of the Dementia and Ageing Research Team at The University of Manchester and their associated networks over an eight-year period (2011–2019) with the aim of constructing a definition of ‘being in the moment’ and situating it within a continuum of moments that could be used to contextualise and frame the lived experience of dementia. Using the approach formulated by Pound et al. (2005) in synthesising qualitative studies, we identified this continuum of moments as comprising four sequential and interlinked steps: (a) ‘creating the moment’, defined as the processes and procedures necessary to enable being in the moment to take place – the time necessary for this to occur can range from fleeting to prolonged; (b) ‘being in the moment’, which refers to the multi-sensory processes involved in a personal or relational interaction and embodied engagement – being in the moment can be sustained through creativity and flow; (c) ‘ending the moment’, defined as when a specific moment is disengaged – this can be triggered by the person(s) involved consciously or subconsciously, or caused by a distraction in the environment or suchlike; and (d) ‘reliving the moment’, which refers to the opportunity for the experience(s) involved in ‘being in the moment’ to be later remembered and shared, however fragmentary, supported or full the recall.

For patients participating in trauma-focused psychotherapies for posttraumatic stress disorder (PTSD), such as cognitive processing therapy (CPT), pretreatment characteristics may moderate treatment effectiveness. For instance, preexisting supportive relationships may encourage skill utilization or provide contrasts to maladaptive cognitive biases highlighted in trauma-focused treatments for PTSD. Such pretreatment characteristics are important to study in rural individuals, who may experience barriers to initiating and completing treatment. The aim of this study was to examine whether pretreatment social support, measured using the Medical Outcomes Study Social Support Survey, would moderate the association between CPT duration (i.e., number of sessions attended) and change in PTSD symptoms, using data from a pragmatic randomized controlled trial of a telemedicine-based collaborative care intervention for rural veterans (N = 225). Social support moderated the association between CPT duration and PTSD symptom change, B = -0.016, SE = -.006; 95% CI [-0.028, -0.005], such that increased duration was associated with more PTSD symptom change only at average or higher levels of support. This effect was found for overall and emotional support but not tangible support. Additionally, on average, among participants who attended eight or more CPT sessions, only those at or above 1 standard deviation above the mean social support score demonstrated a reliable change in PTSD symptoms. The results indicate that the link between CPT treatment duration and treatment outcomes may be stronger for veterans with higher levels of pretreatment social support.

In this paper, we present reflections from three research studies that have engaged with creative approaches to qualitative research with people living with dementia. Creative approaches to qualitative research are increasingly advocated within dementia research as they foreground alternative routes to expression and can facilitate flexible, meaningful participation. Such approaches are typically cited as illuminating people’s lived experiences as they often enable nuanced understandings around how people with dementia engage in the world around them. Yet creative approaches to research with people living with dementia involve specific complexities that require rigorous planning, generous timelines, and interdisciplinary research teams. It is important to examine the role of the researcher(s) in the development and application of creative approaches, as this impacts the extent to which the voices and experiences of people living with dementia are authentically heard and felt throughout the research. In this reflective article, we come together as three researchers who have used a range of creative and sensory approaches to understand the everyday lived experiences of people living with dementia in different contexts. We present examples taken from three doctoral research studies in which we navigated the creative research space to ensure the voices of people living with dementia are placed centrally and actively within the research process. We pay particular attention to the creative reflexive processes used in each example and explore what ethical research practices look and feel like in the context of creative research with people living with dementia. Our critical reflections lead us to discuss the opportunities that embracing creative approaches may afford in future research with people living with dementia.

This chapter explores the understanding behind the emerging dementia-friendly communities (DFC) agenda. A five-year international qualitative study investigated the experience of the neighbourhood for people living with dementia and their care partners. Despite efforts to place people with dementia at the heart of the DFC movement, limited attention has been given to their actions and agency in a neighbourhood context. Spatial and affective practices of people living with dementia highlight the idea of ‘enabling neighbourhoods’. The chapter also notes the importance of engagement with diverse places and social opportunities in the neighbourhood to managing life with dementia alongside keeping up with wellbeing and social health. Ultimately, research shows the value of attending to the ‘doing’ of the neighbourhood, the transformative impact it can have on social relations over time, and the influence of people with dementia as agents of change.

This chapter tackles the report findings of Neighbourhoods: Our People, Our Places (N: OPOP) based on the experiences of people living alone with dementia from Greater Manchester, Scotland and Sweden. It also examines a subset of data from the N: OPOP project of people living alone with dementia establishing social networks and relationships in a neighbourhood context. Multiple data-collection methods were used such as semi-structured interviews, walking interviews, guided home tours and social network mapping, which were conducted with fourteen community-dwelling people living alone with dementia situated across the three international study sites. Thematic analysis revealed four main themes: making the effort to stay connected, befriending by organisations and facilitated friendships, the quiet neighbourhood atmosphere, and changing social connections. Moreover, the analysis suggests that people living alone with dementia were active agents that took control of finding and maintaining relationships and social networks in a lived neighbourhood. The findings indicate the need to raise awareness on policy, practice and creative ways to connect.

Domestic dogs are trained using a range of different methods, broadly categorised as reward based (positive reinforcement/negative punishment) and aversive based (positive punishment/negative reinforcement). Previous research has suggested associations between use of positive punishment-based techniques and undesired behaviours, but there is little research investigating the relative welfare consequences of these different approaches. This study used a judgement bias task to compare the underlying mood state of dogs whose owners reported using two or more positive punishment/negative reinforcement based techniques, with those trained using only positive reinforcement/negative punishment in a matched pair study design. Dogs were trained to discriminate between rewarded and unrewarded locations equidistant from a start box, and mean latencies recorded. Their subsequent latency to intermediate ‘ambiguous’ locations was recorded as an indication of whether these were perceived as likely to contain food or not. Dogs trained using aversive methods were slower to all ambiguous locations. This difference was significant for latency to the middle (Wilcoxon Z = − 2.380, P = 0.017), and near positive (Wilcoxon Z = − 2.447, P = 0.014) locations, suggesting that dogs trained using coercive methods may have a more negative mood state, and hence that there are welfare implications of training dogs using such methods.

This chapter looks into the significance of neighbourhoods for people living with dementia in line with social connection, engagement, and interaction. It also includes the nature of associations people have in the immediate locale in relation to geographic proximity. In literature, outdoor spaces, built environments, and everyday technologies are identified as the three domains of activity for neighbourhoods. According to the ESRC/NIHR-funded Neighbourhoods: Our People, Our Places research, relationships are constituted through a relationship sense of place that can facilitate belonging and inclusion. Moreover, local social connections act as channels for information, interaction, support, and metaphorical safety nets in exceptional circumstances. However, local connections for people with dementia could extend beyond the conventional neighbourhoods. Viewing neighbourhoods as relational phenomena gives the perspective of understanding the overlooked geographies of everyday life with dementia.

Could biotechnology stop aging? The answer may be yes, no, or something in between, depending on who is being asked and what it means to “stop” aging. For those at one end of the spectrum— life extension seekers (including some deep-pocketed Silicon Valley investors)—the answer is “yes.” They believe biotechnology will lengthen human life spans to range anywhere from 1,000 years to forever. But for most, the answer is more nuanced and in- volves a dream of extended healthspan , rather than immortality. They imagine a future in which people over the age of 65 years are healthy, active, independent, and not burdened by disease, and that this is the norm rather than the exception. “Healthspanners” believe that one day, science will delay the onset of aging-related conditions and, as a side-effect, modestly extend life. Aging as we know it—and dread it—could become ancient history.

In this work, cellulose was extracted from rice husk. Fe3O4 and TiO2 particles were successfully bonded on the cellulose surface via hydroxyl group. The products were confirmed and characterized by Fourier transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), scanning electron microscopy (SEM), X-ray diffraction (XRD) and X-ray photoelectron spectroscopy (XPS). A pressure decay technique was carried out to evaluate CO2 sorption capacity and reusability. In addition, ab Initio calculations were performed. The experimental results show an increase in CO2 sorption ability upon cellulose modification with metal oxides. Titanium dioxide modified cellulose fibers (cellulose-TiO2, 184.1 mg/g at 30 bar and 298.15 K) and iron oxide modified cellulose fibers (cellulose-Fe3O4, 130.6 mg/g at 30 bar and 298.15 K) exhibited enhanced CO2 uptake than nonmodified cellulose (cellulose, 81.6 mg/g under the same conditions). The best CO2/N2 selectivity result was obtained for cellulose-TiO2 (3.56 ± 0.16). Selective capacity of cellulose-TiO2 for CO2/N2 was approximately 270% higher than raw cellulose fibers. CO2 sorption recycling experiments demonstrated high stability and reuse capacity in CO2 capture processes of Cellulose-TiO2.

To ensure patient safety, medical device manufacturers are required by the Food and Drug Administration and other regulatory bodies to perform biocompatibility evaluations on their devices per standards, such as the AAMI-approved ISO 10993-1:2018 (ANSI/AAMI/ISO 10993-1:2018).However, some of these biological tests (e.g., systemic toxicity studies) have long lead times and are costly, which may hinder the release of new medical devices. In recent years, an alternative method using a risk-based approach for evaluating the toxicity (or biocompatibility) profile of chemicals and materials used in medical devices has become more mainstream. This approach is used as a complement to or substitute for traditional testing methods (e.g., systemic toxicity endpoints). Regardless of the approach, the one test still used routinely in initial screening is the cytotoxicity test, which is based on an in vitro cell culture system to evaluate potential biocompatibility effects of the final finished form of a medical device. However, it is known that this sensitive test is not always compatible with specific materials and can lead to failing cytotoxicity scores and an incorrect assumption of potential biological or toxicological adverse effects. This article discusses the common culprits of in vitro cytotoxicity failures, as well as describes the regulatory-approved methodology for cytotoxicity testing and the approach of using toxicological risk assessment to address clinical relevance of cytotoxicity failures for medical devices. Further, discrepancies among test results from in vitro tests, use of published half-maximal inhibitory concentration data, and the derivation of their relationship to tolerable exposure limits, reference doses, or no observed adverse effect levels are highlighted to demonstrate that although cytotoxicity tests in general are regarded as a useful sensitive screening assays, specific medical device materials are not compatible with these cellular/in vitro systems. For these cases, the results should be analyzed using more clinically relevant approaches (e.g., through chemical analysis or written risk assessment).

Primary Subject area Social Paediatrics Background The novel coronavirus (COVID-19) pandemic is a major global threat that emerged in 2020. Many countries have enacted policies such as mandatory school closures, business closures, and self-quarantining to keep people at home and prevent further spread of the virus. Previous research has shown that pandemics and subsequent disease containment measures negatively affect children and families, both psychosocially and economically. Objectives The current study explores the potential psychosocial impacts of the COVID-19 pandemic and subsequent disease containment measures on a number of domains (employment/business, education, finances, medical care, access to medication, technology, children/family, access to community services) through an online survey. The current abstract focuses on the emotional well-being of children and how families have been affected by the restrictions and changes related to the COVID-19 pandemic. Design/Methods Participants were asked to complete an online survey through a secure portal. The survey consisted of questions about household demographics and socio-economic status (SES), as well as five psychometric scales measuring satisfaction with life, psychological well-being, anxiety, depression, and substance use, and specific questions about how the COVID-19 pandemic has impacted respondents’ daily lives in the previously identified domains. This is the first of four longitudinal surveys that will be conducted throughout this study. Results A total of 571 participants completed the survey. Of these participants, 41.3% identified as being a parent or guardian with children under 18. The focus of this abstract is the subset of respondents with children. Roughly three quarters of participants identified that their children were emotionally impacted by COVID-19, the school closures, or missing friends or family (Yes = 46.6%; Somewhat = 30.5%). Parents also reported loss of access to childcare, disruptions to their visits with their children living outside the home, and feeling like they could not access timely medical care for their children. Demographic information and other relevant responses and information can be found in Tables 1 and 2, respectively. Conclusion The impacts of the COVID-19 pandemic will be felt for years to come and will shape an entire generation of children. Even in the current sample, which consisted largely of individuals from medium-high SES households, most reported that children had been impacted emotionally. Understanding and mitigating the impact on children and adapting resources in the short term and the long-term to meet the growing needs of our communities must be top priorities for pediatricians and community service providers.

Objective Evaluate suicide attempt prevalence and potentially related sociodemographic and psychiatric factors among racial and ethnic groups. Methods Between 2012 and 2013, the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) conducted semi-structured interviews with 36,309 adults in the USA. We identified lifetime suicide attempt prevalence and significant predictors for each racial/ethnic group using stratified logistic regressions. Analyses were exploratory without a priori hypotheses. Results Asian/Native Hawaiian/other Pacific Islander and Black individuals had the lowest prevalence of suicide attempts while Alaska Native/American Indian and White individuals had the highest prevalence. Identifying as female and meeting criteria for psychiatric diagnoses featuring mood regulation difficulties (depression, borderline personality disorder, bipolar I disorder) were consistently related to a suicide attempt history across racial and ethnic groups, whereas substance abuse disorders and other sociodemographic factors differed between racial and ethnic groups in their associations with suicide attempt history. Conclusions Although several factors were consistently related to suicide risk across racial and ethnic groups, the prevalence of suicide attempts and overall pattern of related factors were not uniform between racial and ethnic groups. Policy Implications Study findings highlight the importance of considering suicide risk within the context of race and ethnicity both regarding the overall prevalence of risk and in determining personal factors associated with elevated risk. A failure to appreciate experiences related to race and ethnicity may adversely impact suicide risk assessment and treatment, ultimately contributing to health disparities. Results suggest that additional research is warranted. Supplementary Information The online version contains supplementary material available at 10.1007/s40615-021-01115-3.

Background Posttraumatic stress disorder (PTSD) is associated with sexual difficulties but the nuances of this relationship remain elusive. Research has increased in recent years, most notably following publication of several reviews in 2015. Aim This systematic review examines the relationship between PTSD and sexual difficulties in veterans/military personnel. Methods A systematic review was conducted using PRISMA guidelines in PsycINFO and PubMed databases for studies examining a diagnosis of PTSD or PTSD severity in relation to a range of sexual difficulties. Forty-three studies were identified that met inclusion and exclusion criteria for this review. RESULTS PTSD was associated with increased risk of experiencing at least one sexual difficulty. PTSD was most clearly associated with overall sexual function, sexual desire, sexual satisfaction, and sexual distress. Results were mixed for sexual arousal, orgasm function, erectile dysfunction, premature ejaculation, sexual pain, and frequency of sexual activity. PTSD symptom clusters of avoidance and negative alterations in cognition/mood were most commonly associated sexual difficulties. Few studies compared results by gender and trauma type. Clinical Implications Clinicians should inquire about sexual health in relation to PTSD symptoms and target avoidance and negative mood symptoms by incorporating sexual exposure assignments and sexual activation exercises when appropriate. Strengths & Limitations This systematic review synthesizes an extensive literature that has grown substantially in the past 5 years and includes studies with low to moderate risk of bias. Limitations of the existing literature include challenges differentiating between PTSD and depression, inconsistent measurement of PTSD and trauma histories, inconsistent operationalization and measurement of sexual outcomes, and largely cross-sectional study designs. CONCLUSION PTSD is linked to a range of sexual outcomes. The current literature suggests that PTSD is associated with sexual difficulties related to both the sexual response cycle (ie, sexual desire) and one’s emotional relationship to sexual activity (eg, sexual distress). More research is needed to increase confidence in findings.

In a Jetsons episode from 60 years ago, Elroy, the youngest Jetson, tries to get out of taking a space calculus test at school by telling his mom he’s sick. “I think I have Venus Virus,” he says. His mom doubts him, but summons a doctor anyway. She presses a large red button in their living room and a screen rolls down from the ceiling. On it, a doctor instantly appears to evaluate Elroy. “Venus Virus? Oh, that can be catching,” the doctor says, donning a mask.

Personal digital media such as photos, music and films play a pervasive part in contemporary life by helping us to remember the past, communicate with each other and represent our identity to others. In this chapter, we explore the value of such media for supporting well-being in older age, drawing on concepts from literatures on art, reminiscence and music therapy. Theoretically, we argue for a new category of assistive technologies involving media creation and consumption to enhance well-being. We propose a framework for understanding and designing such assistive media systems which highlights the interaction between media item, author and audience. This framework is then illustrated through early attempts to explore a new kind of digital story therapy for people with dementia in a residential care setting. We conclude with recommendations for the design of future ‘assistive media’ systems and experiences that might enhance not only the lives of people with dementia, but also those around them.

Romantic partners' accommodation of trauma survivors' posttraumatic stress disorder (PTSD) symptoms (e.g., taking on tasks, survivors avoid participating in social withdrawal) is associated with lower relationship satisfaction for both partners and survivors. Little is known about associations of partner accommodation with other aspects of relationship functioning, like intimacy. Sixty-four male military veterans with at least subclinical PTSD and their partners participated in a 2-week daily diary study. Veterans completed nightly measures of PTSD symptoms, while female partners completed nightly measures of accommodating behaviors performed that day. Both partners reported feelings of intimacy each night. Multilevel models revealed that accommodation was significantly, negatively associated with feelings of intimacy, with stronger effects for partners (t = -8.70) than for veterans (t = -5.40), and stronger effects when veterans had lower (t = -7.43) rather than higher (t = -5.20) levels of daily PTSD symptoms. Therapists should consider accommodating behaviors as a potential impediment to relationship intimacy, particularly when veterans have less severe symptoms of PTSD. Accommodating behaviors are an ideal treatment target in behavioral couple therapies.La adaptación de las parejas románticas a los síntomas del trastorno por estrés postraumático (TEPT) de los sobrevivientes de traumas (p. ej.: hacerse cargo de tareas que los sobrevivientes evitan, participar en el aislamiento social) está asociada con una menor satisfacción con la relación tanto para las parejas como para los sobrevivientes. Se sabe poco acerca de las asociaciones de la adaptación de la pareja con otros aspectos del funcionamiento de la relación, como la intimidad. Sesenta y cuatro militares veteranos con al menos TEPT subclínico y sus parejas participaron en un estudio de registro diario de dos semanas. Los veteranos completaron mediciones nocturnas de los síntomas de TEPT, mientras que las parejas femeninas completaron mediciones nocturas de conductas de adaptación realizadas ese día. Ambas parejas informaron sentimientos de intimidad cada noche. Los modelos multinivel revelaron que la adaptación estuvo asociada considerablemente y negativamente con sentimientos de intimidad, con efectos más fuertes para las parejas (t = −8.70) que para los veternos (t = −5.40), y con efectos más fuertes cuando los veteranos tuvieron niveles más bajos (t = −7.43), en lugar de más altos, (t = −5.20) de síntomas diarios de TEPT. Los terapeutas deben sopesar las conductas de adaptación como un posible impedimento para la intimidad en la relación, particularmente cuando los veteranos tienen síntomas menos graves de TEPT. Las conductas de adaptación son el objetivo ideal del tratamiento en las terapias conductuales de pareja.恋爱伴侣对于创伤幸存者创伤后压力综合症(PTSD)症状(例如做幸存者回避的工作,加入到社交退缩行为)的适应和伴侣以及幸存者双方较低的关系满意度相关。我们对于伴侣适应和其他例如亲密方面关系功能之间的关联知之甚少。64名至少还有亚临床PTSD的退役军人及其伴侣参与了一项为期2周的每日日记研究。退役军人还完成了每晚PTSD症状测量,而其女性伴侣完成每晚适应行为测量。伴侣双方报告了每晚亲密情感。多层面模型显示适应和亲密情感明显负面相关,而其对伴侣的影响(t = −8.70)大于对退役军人影响(t = −5.40),并且退役军人PTSD程度较低(t = −7.43)的情况比其较高的情况(t = −5.20) 影响更大。心理咨询师应该考虑适应行为作为关系亲密度的潜在阻碍,特别是当退役军人PTSD症状较轻的情况下。适应行为是针对行为伴侣心理咨询的一个理想治疗方法。.

Around 2008, endoscopists David Carr-Locke and Petros Benias began to notice an unfamiliar pattern in the bile duct during endomicroscopy, which didn't look like anything they knew from pathology. Their confusion as to what it was persisted, so they brought their observations to their colleague, pathologist Neil Theise. Eventually, a larger group of researchers worked to figure out what exactly they were seeing in the bile duct samples. Their ultimate conclusion was that the structure is part of a network of connected interstitial spaces.

A straightforward and solvent-free synthesis of various secondary and tertiary cyanoformamides from carbamoyl imidazoles and TMSCN has been developed. Both cyclic and acyclic carbamoyl imidazoles react smoothly to form the relevant cyanoformamides in excellent yields, often within minutes.

Sufferers of osteoarthritis are all too aware of the daily pain and impairment of swollen joints, of having to give up sports-and jobs-due to cartilage defects. What they may be less aware of is that three-dimensional (3-D) bioprinting and bioink technologies are being developed to revolutionize the existing (and often imperfect) treatments available to them.