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The number of people following a vegan diet in the UK is increasing. Eating disorder clinicians are anecdotally reporting that more of their patients with anorexia nervosa are wanting to follow a vegan diet. The relationship between veganism and eating disorders is unclear. A fictitious scenario is used to explore these issues. An approach is described that clinicians may follow to help patients to understand the potential relationship between their eating disorder and veganism. The human rights issues this involves are also explored. It is hoped that this article will make readers more aware of this complex issue and the impact it can have on engagement with services and on treatment options.
This chapter suggests tools and skills that a language revitalizer might need when incorporating new technology into language revitalization. It emphasizes that skills can be acquired gradually on the basis of current needs. Technology should be integrated appropriately into language teaching, with an iterative process for evaluating which tools are the right ones for the job. Issues around privacy and safety (particularly important when working with children) and ownership (which has historically affected Indigenous and minority communities disproportionately) are addressed. Appropriate use of technology in revitalization contexts is discussed, with examples of apps that may be useful for particular purposes and domains. Much of what can be accomplished with technology is best seen as an extension of learning, and one should always choose the resource to match the need, rather than being driven by the technology. The capsules describe the applications of video documentation in Passamaquoddy to new language revival projects; lessons learned from the development of online resources in Welsh; and the digital inclusion initiative Rising Voices.
Autism spectrum disorders (ASDs) are a group of lifelong neurodevelopmental disorders characterised by difficulties in social interactions and social communication, and restricted and repetitive behaviours. Relative to the general population, individuals with ASDs are likely to be overrepresented in secure psychiatric care and custodial settings. Outcomes vary and can be problematic in the context of co-occurring intellectual disability, psychiatric disorder and challenging behaviours. To date, there is little in the way of specialised clinical guidance on the prescription of psychotropic medicines for individuals with ASDs, particularly information on any differences in efficacy and/or tolerability of specific medications. This review summarises the key research to date on the prescription of psychotropic medication in ASD with and without comorbid psychiatric or neurodevelopmental disorders, within the context of the existing clinical guidance. Some critical analysis is provided to aid clinicians in following a safe, effective and individualised approach to prescribing for people with ASDs.
The British Columbia Farmers’ Market Nutrition Coupon Program (FMNCP) provides low-income households with coupons valued at $21/week for 16 weeks to purchase healthy foods in farmers’ markets. Our objective was to explore FMNCP participants’ experiences of accessing nutritious foods, and perceived program outcomes.
This study used qualitative description methodology. Semi-structured interviews were conducted with FMNCP participants during the 2019 farmers’ market season. Directed content analysis was used to analyse the data whereby the five domains of Freedman et al’s framework of nutritious food access provided the basis for an initial coding scheme. Data that did not fit within the framework’s domains were coded inductively.
One urban and two rural communities in British Columbia, Canada.
28 adults who were participating in the FMNCP.
Three themes emerged: Autonomy and Dignity; Social Connections and Community Building; and Environmental and Programmatic Constraints. Firstly, the program promoted a sense of autonomy and dignity through financial support, increased access to high-quality produce, food-related education and skill development, and mitigating stigma and shame. Secondly, shopping in farmers’ markets increased social connections and fostered a sense of community. Finally, participants experienced limited food variety in rural farmers’ markets, lack of transportation, and challenges with redeeming coupons.
Participation in the FMNCP facilitated access to nutritious foods and enhanced participants’ diet quality, well-being and health. Strategies such as increasing the amount and duration of subsidies, and expanding programs may help improve participants’ experiences and outcomes of farmers’ market food subsidy programs.
Bipolar disorder is a chronic mental health condition, which can result in functional impairment despite medication. A large evidence base supports use of psychological therapies and structured care in the treatment of mood disorders, but these are rarely implemented. e-Pathways are digital structures that inform and record patient progress through a healthcare system, although these have not yet been used for bipolar disorder.
To assess the perceived benefits and costs associated with implementing a collaborative NICE-informed e-pathway for bipolar disorder.
Healthcare professionals and people with bipolar disorder attended a workshop to share feedback on e-pathways. Data were collected through questionnaires (n = 26) and transcription of a focus group, analysed qualitatively by a framework analysis.
Patients and healthcare professionals welcomed the development of an e-pathway for bipolar disorder. There were five elements to the framework: quality and delivery of care, patient–clinician collaboration, flexibility and adaptability, impact on staff and impact on healthcare services.
Identification of benefits and costs ensures that future development of e-pathways addresses concerns of healthcare professionals and people with bipolar disorder, which would be essential for successful implementation. Recommendations for this development include making e-pathways less complicated for patients, ensuring sufficient training and ensuring clinicians do not feel their skills become invalidated. Limitations of the study, and directions for future research, are discussed.
ABSTRACT IMPACT: Identifying an important pathway in treatment resistant TNBC will allow for the future development of clinical therapeutics specific for this disease. OBJECTIVES/GOALS: Triple Negative Breast Cancer (TNBC) is a subtype of breast cancer characterized by negative expression of estrogen receptor, progesterone receptor, and HER2/neu amplification. It resists therapies and has a high recurrence rate after resection. The goal of my research is to identify & characterize a TNBC pathway for future development of therapies. METHODS/STUDY POPULATION: The project uses a combination of cell lines, patient derived xenograft (PDX) models, as well as patient databases. Standard cellular and molecular biology techniques will be used including: Cell culture, qPCR, western blotting, and flow cytometry. RESULTS/ANTICIPATED RESULTS: LKB1 is a master kinase that activates 14 possible downstream kinases. The signaling pathway has been demonstrated to play a role in energy homeostasis and metabolism. Mutation of LKB1 signaling results in Peutz-Jeghers Syndrome and is associated with neoplasias of the lung, pancreas, and breast. Based on preliminary analysis, overexpression of LKB1 by shRNA in TNBC cell lines results in suppression of EMT and reduction of the cancer stem cell population. Additional studies show that LKB1 overexpression has no effect on growth rate in 2D culture while significant reduction in 3D mammosphere formations can be seen. Downstream studies using commercially available SIK1 inhibitor HG-9-91-01 is able to induce a larger fraction of CSC from reduced LKB1 overexpression as well as from baseline levels. DISCUSSION/SIGNIFICANCE OF FINDINGS: Overall, our results suggest that LKB1 acts through SIK1 to suppress EMT and the generation of cancer stem cells. This results in reduced cancer functionality, as evidenced by inhibition of mammosphere formation. These results establishes a foundation for future mechanistic studies on the LKB1 axis and its mechanisms in TNBC.
The study of prosocial behavior has been an active area of research in social psychology that dates back to the beginnings of the last century. (For a review see Penner et al., 2005,) This large body of literature includes a diverse range of phenomena centering around the origins and tendencies of humans helping other humans, including traits such as empathy. In psychology the term “prosocial behavior” is typically used to indicate a behavior that provides benefit to another person. However, this same term, and all that it implies, has been increasingly applied to nonhuman vertebrate animal behavior and the neural mechanisms regulating these behaviors. It is within this latter context that the term prosocial has been used rather loosely with no clear definitions provided.
High dietary phosphorus (P), particularly soluble salts, may contribute to chronic kidney disease development in cats. The aim of the present study was to assess the safety of P supplied at 1 g/1000 kcal (4184kJ) from a highly soluble P salt in P-rich dry format feline diets. Seventy-five healthy adult cats (n 25/group) were fed either a low P control (1·4 g/1000 kcal [4184kJ]; Ca:P ratio 0·97) or one of two test diets with 4 g/1000 kcal (4184 kJ); Ca:P 1·04 or 5 g/1000 kcal (4184kJ); Ca:P 1·27, both incorporating 1 g/1000 kcal (4184 kJ) sodium tripolyphosphate (STPP) – for a period of 30 weeks in a randomised parallel-group study. Health markers in blood and urine, glomerular filtration rate, renal ultrasound and bone density were assessed at baseline and at regular time points. At the end of the test period, responses following transition to a commercial diet (total P – 2·34 g/1000 kcal [4184kJ], Ca:P 1·3) for a 4-week washout period were also assessed. No adverse effects on general, kidney or bone (skeletal) function and health were observed. P and Ca balance, some serum biochemistry parameters and regulatory hormones were increased in cats fed test diets from week 2 onwards (P ≤ 0·05). Data from the washout period suggest that increased serum creatinine and urea values observed in the two test diet groups were influenced by dietary differences during the test period, and not indicative of changes in renal function. The present data suggest no observed adverse effect level for feline diets containing 1 g P/1000 kcal (4184 kJ) from STPP and total P level of up to 5 g/1000 kcal (4184 kJ) when fed for 30 weeks.
This paper sheds new light on the drivers of civil service reform in US states. We first demonstrate theoretically that divided government is a key trigger of civil service reform, providing nuanced predictions for specific configurations of divided government. We then show empirical evidence for these predictions using data from the second half of the 20th century: states tended to introduce these reforms under divided government, and in particular when legislative chambers (rather than legislature and governor) were divided.
Establishing an evidence base for the clinical management of catatonia is made difficult by the heterogeneous nature of the condition and the limited understanding of its pathophysiology. Benzodiazepines are a mainstay of treatment. The Cochrane review discussed identified only one eligible study (17 participants with catatonia who received either lorazepam or oxazepam), which found no difference on the single outcome measure (a 50% improvement on a visual analogue scale). This commentary discusses the findings in more detail, and considers what constitutes high-quality evidence for the acute treatment of catatonia, why there is such a paucity of randomised controlled trials (RCTs) on the topic and whether RCTs are both feasible and appropriate for the condition.
For a number of years there has been nothing at all unusual about the United Kingdom finding itself in a state of constitutional upheaval; indeed, for some time, this has been the UK constitution’s default setting. This has sometimes been as a result of long-anticipated and carefully planned reforms, such as the enactment, in the late 1990s, of legislation to give domestic effect to the European Convention on Human Rights and to introduce devolved systems of government in Scotland, Wales and Northern Ireland. In contrast, more recent upheaval is attributable to often unexpected reactions to often unexpected events. For example, legislation making substantial changes to the devolution scheme in Scotland – providing, among other things, for the constitutional permanence of the Scottish Parliament and Government – was enacted to implement panicked promises made by UK politicians in the dying days of the Scottish independence referendum campaign, at which point a vote in favour of independence seemed a distinct possibility. And then, needless to say, there is Brexit – about which it is almost impossible to be guilty of hyperbole when describing its constitutional implications, so numerous and potentially far-reaching are they.
Individuals with schizophrenia are at higher risk of physical illnesses, which are a major contributor to their 20-year reduced life expectancy. It is currently unknown what causes the increased risk of physical illness in schizophrenia.
To link genetic data from a clinically ascertained sample of individuals with schizophrenia to anonymised National Health Service (NHS) records. To assess (a) rates of physical illness in those with schizophrenia, and (b) whether physical illness in schizophrenia is associated with genetic liability.
We linked genetic data from a clinically ascertained sample of individuals with schizophrenia (Cardiff Cognition in Schizophrenia participants, n = 896) to anonymised NHS records held in the Secure Anonymised Information Linkage (SAIL) databank. Physical illnesses were defined from the General Practice Database and Patient Episode Database for Wales. Genetic liability for schizophrenia was indexed by (a) rare copy number variants (CNVs), and (b) polygenic risk scores.
Individuals with schizophrenia in SAIL had increased rates of epilepsy (standardised rate ratio (SRR) = 5.34), intellectual disability (SRR = 3.11), type 2 diabetes (SRR = 2.45), congenital disorders (SRR = 1.77), ischaemic heart disease (SRR = 1.57) and smoking (SRR = 1.44) in comparison with the general SAIL population. In those with schizophrenia, carrier status for schizophrenia-associated CNVs and neurodevelopmental disorder-associated CNVs was associated with height (P = 0.015–0.017), with carriers being 7.5–7.7 cm shorter than non-carriers. We did not find evidence that the increased rates of poor physical health outcomes in schizophrenia were associated with genetic liability for the disorder.
This study demonstrates the value of and potential for linking genetic data from clinically ascertained research studies to anonymised health records. The increased risk for physical illness in schizophrenia is not caused by genetic liability for the disorder.
Abnormal processing of social feedback is an important contributor to social dysfunction in depression, however the exact mechanisms remain unclear. One important factor may be the extent to which social processing depends on expectations, in particular whether social feedback confirms or violates expectations.
To answer this question, we studied behavioral and brain responses during the evaluative processing of social feedback in 25 individuals with subthreshold depression (SD) and 25 healthy controls (HCs). Participants completed a Social Judgment Task in which they first indicated expectation about whether a peer would like them or not, and then received peer's feedback indicating acceptance or rejection.
Individuals with SD who reported greater depressive symptoms gave fewer positive expectations. Compared to HCs, individuals with SD showed reduced activation in the medial prefrontal cortex when expecting positive feedback. They also exhibited increased dorsal anterior cingulate cortex after receipt of unexpected social rejection, and reduced ventral striatum activity after receipt of unexpected social acceptance.
The observed alternations are specific to unexpected social feedback processing and highlight an important role of expectancy violation in the brain dysfunction of social feedback perception and evaluation in individuals at risk for depression.
This study investigates children's real time incrementation of language change as it is impacted by community-wide patterns of linguistic variability. The investigation combines apparent time analyses across an age-stratified sample of adult speakers, with real time analyses across a panel of speakers spanning childhood to adolescence. Three variables are analysed: GOOSE-fronting, a socially unmarked change; TH-fronting, a socially stigmatised, rapidly expanding change; and T-glottaling, a socially stigmatised, steadily shifting change. Variables are selected based on their social and generational profiles which present learners with more or less challenging community patterns to extract. Real time analyses confirm that community variance impacts on speakers’ ability to increment change in real time. Findings provide support for the momentum-based model of language change and builds on Labov's (2012:267) theory of the ‘outward orientation’ of children, which views learners as capable of extracting age vectors from generational differences. (Language change, incrementation, real time, GOOSE-fronting, TH-fronting, T-glottaling)*
We derive and analyse an energy to model lipid raft formation on biological membranes involving a coupling between the local mean curvature and the local composition. We apply a perturbation method recently introduced by Fritz, Hobbs and the first author to describe the geometry of the surface as a graph over an undeformed Helfrich energy minimising surface. The result is a surface Cahn–Hilliard functional coupled with a small deformation energy. We show that suitable minimisers of this energy exist and consider a gradient flow with conserved Allen–Cahn dynamics, for which existence and uniqueness results are proven. Finally, numerical simulations show that for the long-time behaviour raft-like structures can emerge and stabilise, and their parameter dependence is further explored.