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Abstract 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.

Current trends in gerontology conceptualize Virtual Reality (VR) as a tool for rehabilitation, lauding its potential for cognitive rehabilitation or as an intervention to reduce cognitive function decline. However, we must take a critical stance and identify not just the potential positive impact, but also how things may go wrong without appropriate guidelines, and the need for careful design around the interaction affordances of the technology. We conducted co-discovery and co-design workshops involving expert stakeholders and older adults ( N = 25) over a period of 6 months, involving practical activities including user personas and focus groups to understand the complexities of loneliness and identify possible solutions with VR. Based on our findings we focus our argument on two key factors in the conceptualization of loneliness: spaces, and activities which may take place within said spaces. We present our reconceptualization of VR as a tool for group activities instead of passive consumption of content and make suggestions to the community for reducing feelings of loneliness with VR.

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.

Abstract 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.

Abstract Background Real-world comparisons of biologic treatment outcomes for ulcerative colitis (UC) or Crohn’s disease (CD) patients are limited. We sought to evaluate the real-world effectiveness of vedolizumab (VDZ) and anti-tumor necrosis factor alpha (anti-TNFα) in UC and CD patients in Germany. Methods A retrospective chart review (15 sites) investigated UC and CD patients who were biologic-treatment naïve (biologic-naïve) or had received no more than one prior anti-TNFα before initiating treatment with VDZ or anti-TNFα between 15 July 2014 and 20 October 2015. Kaplan-Meier analyses assessed time to first chart-documented clinical remission (CR) and symptom resolution (UC: rectal bleeding [RB], stool frequency [SF]; CD: abdominal pain [AP], liquid stools [LS]) and outcome duration. Results A total of 133 UC (76 VDZ; 57 anti-TNFα) and 174 CD (69 VDZ; 105 anti-TNFα) patients were included. By Week 26, estimated cumulative rates of patients achieving CR or symptom resolution with VDZ vs anti-TNFα treatment were for UC: CR, 53.7% vs 31.7%; RB, 66.8% vs 55.8%; and SF, 59.8% vs 50.7%, respectively; and for CD: CR, 14.4% vs 32.8%; AP, 62.5% vs 56.0%; and LS, 29.9% vs 50.3%, respectively. Outcomes were sustained similarly between treatments, except RB (VDZ vs anti-TNFα: median 38.1 vs 15.1 weeks, P = 0.03). Treatment-related adverse events occurred in 5.3% vs 7.0% (UC) and 8.7% vs 19.0% (CD) of VDZ vs anti-TNFα patients, respectively. Conclusions Although there were differences in CR, symptom resolution, and safety profiles, real-world data support both VDZ and anti-TNFα as effective treatment options in UC and CD.

Introduction Smoking reduction can lead to increased success in quitting. This study aims to determine if a client-focused motivational support package for smoking reduction (and quitting) and increasing (or otherwise using) physical activity (PA) can help smokers who do not wish to quit immediately to reduce the amount they smoke, and ultimately quit. This paper reports the study design and methods.Methods and analysis A pragmatic, multicentred, parallel, two group, randomised controlled superiority clinical trial, with embedded process evaluation and economics evaluation. Participants who wished to reduce smoking with no immediate plans to quit were randomised 1:1 to receive either (1) tailored individual health trainer face-to-face and/or telephone support to reduce smoking and increase PA as an aid to smoking reduction (intervention) or (2) brief written/electronic advice to reduce or quit smoking (control). Participants in both arms of the trial were also signposted to usual local support for smoking reduction and quitting. The primary outcome measure is 6-month carbon monoxide-confirmed floating prolonged abstinence following participant self-reported quitting on a mailed questionnaire at 3 and 9 months post-baseline. Participants confirmed as abstinent at 9 months will be followed up at 15 months.Ethics and dissemination Approved by SW Bristol National Health Service Research Committee (17/SW/0223). Dissemination will include publication of findings for the stated outcomes, parallel process evaluation and economic evaluation in peer-reviewed journals. Results will be disseminated to trial participants and healthcare providers.Trial registration number ISRCTN47776579; Pre-results.

Posttraumatic stress disorder (PTSD) is a risk factor for cardiovascular disease (CVD) and diabetes. Dedert and colleagues hypothesized a model whereby PTSD leads to poor health behaviors, depression, and pre-clinical disease markers, and that these factors lead to CVD and diabetes (Ann Behav Med, 2010, 61–78). This study provides a preliminary test of that model. Using data from a mailed cross-sectional survey conducted 2012–2013, path analysis was conducted among N = 657 with complete demographic data. We first analyzed the hypothesized model, followed by four alternatives, to identify the best-fitting model. The alternate model that specified pathways from depression to health behaviors had the best fit. Contrary to hypotheses, higher PTSD symptoms were associated with better physical activity and diet quality. Of the specific indirect pathways from PTSD to Body Mass Index (BMI), only the path through depression was significant. Higher depression symptoms were significantly associated with less physical activity, poorer diet, and greater likelihood of smoking. In addition, the specific indirect effect from depression to BMI through physical activity was significant. Current smoking and higher BMI were associated with greater likelihood of diabetes, and hypertension was associated with greater likelihood of CVD. PTSD symptoms may increase risk for CVD and diabetes through the negative impact of depression on health behaviors and BMI. With or without PTSD, depression may be an important target in interventions targeting cardiovascular and metabolic diseases among veterans. Keywords: PTSD, Depression, Cardiovascular disease, Diabetes, Health behavior

This article focuses on the use of a participatory social network mapping method with family carers. This is one of a suite of methods developed in a 5-year qualitative multi-centre project exploring how neighbourhoods support, enable or disable people with dementia and their families to live well in their communities. The article considers how mapping provides insights into family support networks, revealing the fluidity of support and care within relationships as well as providing opportunity for individuals to represent the complexities of their relationships with more and less significant others. However, the potential offered by the approach goes beyond those of visual representations of networks and contacts. Paying attention to the co-production process, as well as the reflexive dialogue that emerges in the exchange between researcher, participants, and the maps themselves, we consider how the maps emerge as affective artifacts, weighted with emotion.

The PI3K/AKT signaling pathway plays a role in most cellular functions linked to cancer progression, including cell growth, proliferation, cell survival, tissue invasion and angiogenesis. It is generally recognized that hyperactive PI3K/AKT1 are oncogenic due to their boost to cell survival, cell cycle entry and growth-promoting metabolism. That said, the dynamics of PI3K and AKT1 during cell cycle progression are highly nonlinear. In addition to negative feedback that curtails their activity, protein expression of PI3K subunits has been shown to oscillate in dividing cells. The low-PI3K/low-AKT1 phase of these oscillations is required for cytokinesis, indicating that oncogenic PI3K may directly contribute to genome duplication. To explore this, we construct a Boolean model of growth factor signaling that can reproduce PI3K oscillations and link them to cell cycle progression and apoptosis. The resulting modular model reproduces hyperactive PI3K-driven cytokinesis failure and genome duplication and predicts the molecular drivers responsible for these failures by linking hyperactive PI3K to mis-regulation of Polo-like kinase 1 (Plk1) expression late in G2. To do this, our model captures the role of Plk1 in cell cycle progression and accurately reproduces multiple effects of its loss: G2 arrest, mitotic catastrophe, chromosome mis-segregation / aneuploidy due to premature anaphase, and cytokinesis failure leading to genome duplication, depending on the timing of Plk1 inhibition along the cell cycle. Finally, we offer testable predictions on the molecular drivers of PI3K oscillations, the timing of these oscillations with respect to division, and the role of altered Plk1 and FoxO activity in genome-level defects caused by hyperactive PI3K. Our model is an important starting point for the predictive modeling of cell fate decisions that include AKT1-driven senescence, as well as the non-intuitive effects of drugs that interfere with mitosis.

While 2018 marks the twentieth anniversary of the signing of the Good Friday Agreement (GFA) in Northern Ireland, it also marks the fiftieth anniversary of the civil rights movement and the protests of 1968. One of the key innovations of the Agreement is that it makes issues of rights central to the broader consociational framework, with the entirety of section 6 devoted to ‘Rights, Safeguards and Equality of opportunity.’ This reinforces a perception that the GFA is a culmination of the civil rights movement and its aims; and that the conflict itself was based on issues of rights. The civil rights movement continues to be an enduring collective memory for the nationalist community in post-Agreement Northern Ireland, but since 1998 it has become a site of contested memory. This article considers the civil rights movement’s reputational trajectory since 1998, questioning why this is so, and why it is so ripe for appropriation. It will also examine how different memories of the movement have been mobilized to serve various and sometimes competing agendas. In doing so, it will explore the cultural and political power the memory of ‘rights’ had in the Agreement and in the two decades since.

This study examined the lived experiences of veteran female K-12 teachers who taught during the COVID-19 pandemic. The participants emphasized relationship building, the reevaluation of teaching as a career, the importance of administrative and systemic support, and both positive and negative experiences of teaching during the pandemic. This study offered space for female educators to reflect on their unique experiences, providing insight into the cathartic process of sharing lived experiences in general.

In this study, the author examines six veteran teachers' perspectives on how administrative support has impacted their decision to stay in the same building. Three themes emerged from the interviews: (a) teachers feel administrators should leave them alone; (b) teachers want administrators to protect them; and (c) teachers want to be valued as professionals. In this article, the author argues that research on workplace grief helps explain this contradiction as a protective response.

In this conceptual article the authors advocate for a "fluid curriculum," one that empowers teachers to create equitable, culturally relevant curriculum that is responsive to their students, relevant to their students' lives, and adaptable to the local context in which it is enacted. Because a fluid curriculum places the teacher as creator and students as engaged actors, encouraging, and implementing it may address both the teacher retention and equity issues in U.S. schools.