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The Affective Neuroscience Personality Scales (ANPS) were designed to provide researchers in the mental sciences with an inventory to assess primary emotional systems according to Pankseppian Affective Neuroscience Theory (ANT). The original ANPS, providing researchers with such a tool, was published in 2003. In the present brief communication, about 20 years later, we reflect upon some pressing matters regarding the further development of the ANPS. We touch upon problems related to disentangling traits and states of the primary emotional systems with the currently available versions of the ANPS and upon its psychometric properties and its length. We reflect also on problems such as the large overlap between the SADNESS and FEAR dimensions, the disentangling of PANIC and GRIEF in the context of SADNESS, and the absence of a LUST scale. Lastly, we want to encourage scientists with the present brief communication to engage in further biological validation of the ANPS.
OBJECTIVES/GOALS: Immunomodulatory drugs (IMiDs) are critical to multiple myeloma (MM) disease control. IMiDs act by inducing Cereblon-dependent degradation of IKZF1 and IKZF3, which leads to IRF4 and MYC downregulation (collectively termed the “Ikaros axis”). We therefore hypothesized that IMiD treatment fails to downregulate the Ikaros axis in IMiD resistant MM. METHODS/STUDY POPULATION: To measure IMiD-induced Ikaros axis downregulation, we designed an intracellular flow cytometry assay that measured relative protein levels of IKZF1, IKZF3, IRF4 and MYC in MM cells following ex vivo treatment with the IMiD Pomalidomide (Pom). We established this assay using Pom-sensitive parental and dose-escalated Pom-resistant MM cell lines before assessing Ikaros axis downregulation in CD38+CD138+ MM cells in patient samples (bone marrow aspirates). To assess the Ikaros axis in the context of MM intratumoral heterogeneity, we used a 35-marker mass cytometry panel to simultaneously characterize MM subpopulations in patient samples. Lastly, we determined ex vivo drug sensitivity in patient samples via flow cytometry. RESULTS/ANTICIPATED RESULTS: Our hypothesis was supported in MM cell lines, as resistant lines showed no IMiD-induced decrease in any Ikaros axis proteins. However, when assessed in patient samples, Pom treatment caused a significant decrease in IKZF1, IKZF3 and IRF4 regardless of IMiD sensitivity. Mass cytometry in patient samples revealed that individual Ikaros axis proteins were differentially expressed between subpopulations. When correlating this with ex vivo Pom sensitivity of MM subpopulations, we observed that low IKZF1 and IKZF3 corresponded to Pom resistance. Interestingly, most of these resistant populations still expressed MYC. We therefore assessed whether IMiD resistant MM was MYC dependent by treating with MYCi975. In 88% (7/8) of patient samples tested, IMiD resistant MM cells were sensitive to MYC inhibition. DISCUSSION/SIGNIFICANCE: While our findings did not support our initial hypothesis, our data suggest a mechanism where MYC expression becomes Ikaros axis independent to drive IMiD resistance, and resistant MM is still dependent on MYC. This suggests targeting MYC directly or indirectly via a mechanism to be determined may be an effective strategy to eradicate IMiD resistant MM.
This chapter provides an overview of the common medicines prescribed within mental health care and explores the ways in which personal narratives and social expectations can influence the experience of taking medicines. The chapter also looks at concepts and practices that influence the management of medicines and encourage safe and high-quality use of medicines. These concepts include consumer experience, concordance, and shared decision-making. Facilitating a positive experience of medicinal use requires quality communication and team work, whereby nurses, psychologists, occupational therapists, dietitians, medical practitioners and pharmacists work in partnership with the consumer and carer.
Assessment in the mental health field is a dynamic process of learning, using experience and applying multiple sources of knowledge and evidence. This chapter presents an overview of assessment practices and processes undertaken within formal mental health care and discusses these within the context of consumer–health practitioner partnerships. We start by considering how assessment practices are a prominent feature of understanding a person’s situation and life context, and how these need to be based on the principles of person-centred, trauma-informed care and cultural safety. We discuss the importance of engagement and therapeutic relationships skills in ensuring consumers, carers and family members are meaningfully connected within a process for identifying the mental health problems the person is experiencing. Part of this awareness is reflecting on what it is like for a person to be assessed, and the power dynamics involved in naming experience, symptoms and diagnosis. The chapter then looks at the paradigm of comprehensive assessment, with specific discussions about strengths-based assessment, mental state examination and the roles of different health professionals.
Readers of this book will have thought deeply about how to collaborate with and support people with a mental illness, their families and carers. The preceding chapters have given considerable emphasis to a narrative approach. This final chapter discusses leadership, particularly for new entrants into mental health settings.Effective clinical care is person and family centred. It seeks to understand and involve consumers, carers and families in rich discussions about their needs, preferences and values. This understanding and involvement is combined with evidence-based practice to support consumers in their treatment and recovery goals.At the heart of the decision to take this approach has been the fundamental belief in human connectedness. By working through this text, readers have been challenged to think about how and when to move in new ways when working with resilient and vulnerable people, which is helpful across a range of practice settings when seeking to make a difference in the lives of people experiencing a mental illness. While this is important in providing a theoretical and practical basis for care, it is at the point of care that effective leadership is required.
This chapter introduces the concept of mental illness, how it is diagnosed, and the main diagnostic classification systems used in health practice. The experiences and symptoms of people living with mental illness – according to criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 – are reviewed. It is emphasised that diagnostic criteria can be considered within an overall framework for conversation and engagement between practitioners, consumers, and carers, with the overarching aim of exploring and understanding the best response to distress and treatment approach to promote recovery processes. Criticisms towards diagnostic classification systems are also summarised. Finally, potential effects of the COVID-19 pandemic and its implication for people’s mental health are presented.
To improve maternal health outcomes, increased diversity is needed among pregnant people in research studies and community surveillance. To expand the pool, we sought to develop a network encompassing academic and community obstetrics clinics. Typical challenges in developing a network include site identification, contracting, onboarding sites, staff engagement, participant recruitment, funding, and institutional review board approvals. While not insurmountable, these challenges became magnified as we built a research network during a global pandemic. Our objective is to describe the framework utilized to resolve pandemic-related issues.
Methods:
We developed a framework for site-specific adaptation of the generalized study protocol. Twice monthly video meetings were held between the lead academic sites to identify local challenges and to generate ideas for solutions. We identified site and participant recruitment challenges and then implemented solutions tailored to the local workflow. These solutions included the use of an electronic consent and videoconferences with local clinic leadership and staff. The processes for network development and maintenance changed to address issues related to the COVID-19 pandemic. However, aspects of the sample processing/storage and data collection elements were held constant between sites.
Results:
Adapting our consenting approach enabled maintaining study enrollment during the pandemic. The pandemic amplified issues related to contracting, onboarding, and IRB approval. Maintaining continuity in sample management and clinical data collection allowed for pooling of information between sites.
Conclusions:
Adaptability is key to maintaining network sites. Rapidly changing guidelines for beginning and continuing research during the pandemic required frequent intra- and inter-institutional communication to navigate.
Lithium is viewed as the first-line long-term treatment for prevention of relapse in people with bipolar disorder.
Aims
This study examined factors associated with the likelihood of maintaining serum lithium levels within the recommended range and explored whether the monitoring interval could be extended in some cases.
Method
We included 46 555 lithium rest requests in 3371 individuals over 7 years from three UK centres. Using lithium results in four categories (<0.4 mmol/L; 0.40–0.79 mmol/L; 0.80–0.99 mmol/L; ≥1.0 mmol/L), we determined the proportion of instances where lithium results remained stable or switched category on subsequent testing, considering the effects of age, duration of lithium therapy and testing history.
Results
For tests within the recommended range (0.40–0.99 mmol/L categories), 84.5% of subsequent tests remained within this range. Overall, 3 monthly testing was associated with 90% of lithium results remaining within range, compared with 85% at 6 monthly intervals. In cases where the lithium level in the previous 12 months was on target (0.40–0.79 mmol/L; British National Formulary/National Institute for Health and Care Excellence criteria), 90% remained within the target range at 6 months. Neither age nor duration of lithium therapy had any significant effect on lithium level stability. Levels within the 0.80–0.99 mmol/L category were linked to a higher probability of moving to the ≥1.0 mmol/L category (10%) compared with those in the 0.4–0.79 mmol/L group (2%), irrespective of testing frequency.
Conclusion
We propose that for those who achieve 12 months of lithium tests within the 0.40–0.79 mmol/L range, the interval between tests could increase to 6 months, irrespective of age. Where lithium levels are 0.80–0.99 mmol/L, the test interval should remain at 3 months. This could reduce lithium test numbers by 15% and costs by ~$0.4 m p.a.
Seed retention, and ultimately seed shatter, are extremely important for the efficacy of harvest weed seed control (HWSC) and are likely influenced by various agroecological and environmental factors. Field studies investigated seed-shattering phenology of 22 weed species across three soybean [Glycine max (L.) Merr.]-producing regions in the United States. We further evaluated the potential drivers of seed shatter in terms of weather conditions, growing degree days, and plant biomass. Based on the results, weather conditions had no consistent impact on weed seed shatter. However, there was a positive correlation between individual weed plant biomass and delayed weed seed–shattering rates during harvest. This work demonstrates that HWSC can potentially reduce weed seedbank inputs of plants that have escaped early-season management practices and retained seed through harvest. However, smaller individuals of plants within the same population that shatter seed before harvest pose a risk of escaping early-season management and HWSC.
In a still more profound way than we may think, we are in a period of crisis. Every aspect of the human condition and the social institutions we have made together are today in doubt. In the popular imagination, a crisis is a marker of something vexing that is to be overcome. It enjoys a temporal dimension, seeming to diagnose a present problem at the same time as it already imagines a future moment when the crisis will cease to be, when things will ‘return to normal’. Writing this book together during the the COVID-19 pandemic that began in 2020, that desire for a return to normal life is especially acute, currently providing the basis for a new and common hope all around the world.
And yet, the extent to which we should want to ‘return’ to what we previously understood as ‘normal’ is immediately problematic. The 21st century has already seen an unprecedented cadence of social, environmental, political and economic emergencies that have called into question the belief systems that have hitherto underpinned that normality. These emergencies have resulted in a steady decline in our trust in the value of our democratic political systems, which is seldom attributed to a globalized financial system that is too often responsible for driving these outcomes. The COVID-19 pandemic is providing humanity with an opportunity for a ‘great reset’ with the chance to ‘build back better’, but some are asking if we really want a swift return to the way things were. Instead, should we be choosing something better, a new way of organizing social life such that we can respond to the challenges of today and tomorrow, not yesterday? After all, we learn from Janet Roitman that if everything is in ‘crisis’ then perhaps nothing is. Is our state of perpetual crisis itself just the ‘new normal’? Suddenly emptied of its popular meaning then, how can we be in a period of crisis?
Reflecting on the events of 2008, when the world was first hit by those shockwaves of the global crash that still reverberate today, Sylvia Walby argues that ‘[f] inance caused the crisis.
In order to reveal how crowdfunding is different from mainstream finance, we first need to say something about the typical ways in which people understand and use their money. Since most people believe they cannot be trusted with money and so lack confidence when it comes to finance – a convenient story to tell people if you are running the financial system – it's important to begin our journey in familiar territory. After all, it is still the case that the average school leaver in the UK will have spent longer studying the mechanics of sexual reproduction than they will the workings of financial services products. Many young adults leave full-time education in the mistaken belief that a ‘credit’ card is somehow preferable to a ‘debit’ card – and who can blame them, when ‘credit’ is something that school teaches them to pursue, and ‘debit’ looks rather too much like the word ‘debt’ to be immediately reassuring. This confusion of a means of immediate payment with the idea of personal debt (actually acquired through using a credit card) does little to instil confidence.
This point is exaggerated along gender lines too. As we saw in Chapter One, women have been frequently positioned by mainstream finance as too emotional or irrational to be eligible for access to mainstream products like current and savings accounts. In a 2015 study by Abundance Investment, however, when investors were asked a question about the effects of inflation, or the risk of loss to housing equity from a drop in house prices, it was male respondents who were frequently mistaken in their calculations. Female respondents were far more likely to admit they didn't know the answer, and so only to select responses that they were relatively certain about. What this small study shows is that despite the assumptions of mainstream financial institutions, men are more likely to be ‘confidently wrong’ and women to be ‘cautiously right’, which perhaps hints that one of the main problems we face is who currently runs finance and who typically invests their money.
For the purposes of understanding where crowdfunding and P2P finance fits into our story, next we define some of the basic building blocks of the modern ‘consumer’ experience of money and finance.
Do you know where your money is? If you read ‘money’ and immediately think of cash, then there's a very fair chance that you’ve just pictured notes and coins in a purse or a wallet, or perhaps imagined a big steel vault in a heavily secured basement room in a bank. Either way, you’ve likely sought to reassure yourself that your money is safe. But if you read ‘money’ and instead thought of digital numbers on a smartphone screen, or more imaginatively still, considered your pension, savings and investments, then there's an equally good chance that you don't know exactly where your money is at all. And this suggests a far more fundamental question. If you don't know where your money is, then how do you know what your money is doing?
While most people feel supremely confident that they know precisely what money is, and what they would choose to do should they suddenly have more of it, they are equally uncertain and anxious when it comes to the seemingly more complex matters of finance. At least a part of the problem here is that we tend to use these two terms interchangeably and in different contexts, often misunderstanding their meaning because of it. This is not just a problem for everyday conversations – it creates problems for those of us who study it and who seek to make sense of the way that we think about and use money, and the ways in which financial systems are developed around money.
Throughout this book, our study investigates the stories and myths about money that have led to the creation of different systems of finance, from the eranos loans of ancient Greece to the FinTech and Crypto revolutions of the early 21st century. In so doing, we suggest that finance has not always been the preserve of the elite professional, but is rather something that develops in different ways, bound by time and cultures, and often alters as a response to crisis. The shape of finance at any given moment in history and across cultures, then, depends upon the social relations and moral values that hold those societies together
A unique collaboration between an academic and a practitioner, this book tells the story of money, from ancient Athens to the Bitcoin revolution, to explain how crowdfunding is the way for people to reclaim the power of their money in pursuit of a fairer and greener society.