169 research outputs found

    The development and evaluation of a web-based well-being intervention, for inclusion within an existing health promotion programme, to support and encourage health related lifestyle behaviour change

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    Unhealthy lifestyle behaviours constitute a significant burden of disease, globally. Web-based interventions offer a means to support individuals in adopting and maintaining positive healthy lifestyle behaviours to address and reduce this issue. The health behaviour change literature offers several useful theoretical models which aim to explain or predict the likelihood of successful, individual level, lifestyle behaviour change. Indeed, research findings have shown that digital health interventions informed by these models are more likely to be effective. However, in practice adherence and engagement to web-delivered interventions is often critically low and is associated with reduced effectiveness and cost effectiveness. This thesis developed an emotional well-being intervention (ACTivate your Well-being), for inclusion within an existing lifestyle behaviour change programme ‘Champions for Health’. Thirty-eight anticipated end-users and six stakeholders contributed to a three-staged Participatory Design project which led to the development of a twelve-week intervention, based on Acceptance and Commitment Therapy, and a new study website. Development was informed by two systematic literature reviews. Feasibility and acceptability were proven in a cluster randomised control trial (ISRCTN50074817) which recruited 142 participants. The majority (74%) enrolled on at least one lifestyle behaviour change module and health improvements were observed. Almost half (43%) of those randomised to the intervention arm enrolled onto the well-being intervention. Adherence was low (7%), no one completed the full 12-week programme. A randomised control trial (ISRCTN18190978) then evaluated impact on health behaviour change, adherence and engagement, and well-being. 182 participants were recruited. Adherence remained poor (4%) however some completed the full 12-week programme. Almost half (49%) enrolled on a lifestyle behaviour change module and health improvements were observed in three modules. COVID-19 limited evaluation. The ongoing relevance of the intervention and website is evidenced through its inclusion within the Well-being In work – In work support service, Swansea Bay University Health Board

    Development of a Web-Based Acceptance and Commitment Therapy Intervention to Support Lifestyle Behavior Change and Well-Being in Health Care Staff: Participatory Design Study

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    Background: Positive emotional well-being is associated with healthier lifestyle choices and overall health function, whereas poor mental health is associated with significant economic and psychological costs. Thus, the development of effective interventions that improve emotional well-being is crucial to address the worldwide burden of disease. Objective: This study aims to develop a web-based emotional well-being intervention for use by health care staff using participatory design to consider adherence and engagement from a user perspective. Methods: A 3-staged iterative participatory design process was followed, including multiple stakeholders: researchers, computer scientists, mental health experts, and health care staff. Stage 1 used document analyses, direct observation, and welcome interviews; stage 2 used focus group discussions, rapid prototyping, and usability tasks; and stage 3 evaluated a high-fidelity prototype. Results: Different health care staff (N=38) participated during a sustained period. A structured, sequential, automated, 12-week, web-based emotional well-being intervention based on acceptance and commitment therapy was developed. Freely navigated psychoeducational resources were also included. Conclusions: The iterative and collaborative participatory design process successfully met its objectives. It generated an in-depth understanding of well-being within the workplace and identified barriers to access. The 3-staged process ensured that participants had the opportunity to explore and articulate criteria relevant to their roles over time and reflect on decisions made at each stage

    Divergence of NHS choice policy in the UK: what difference has patient choice policy in England made?

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    OBJECTIVES: To examine the types of choices available to patients in the English NHS when being referred for acute hospital care in the light of the divergence of patient choice policy in the four countries of the UK. METHODS: Case studies of eight local health economies in England, Scotland, Northern Ireland and Wales (two in each country); 125 semi-structured interviews with staff in acute services providers, purchasers and general practitioners (GPs). RESULTS: GPs and providers in England both had a clear understanding of the choice of provider policy and the right of patients to choose a provider. Other referral choices potentially available to patients in all four countries were date and time of appointment, site and specialist. In practice, the availability of these choices differed between and within countries and was shaped by factors beyond choice policy, such as the number of providers in an area. There were similarities between the four countries in the way choices were offered to patients, namely lack of clarity about the options available, limited discussion of choices between referrers and patients, and tension between offering choice and managing waiting lists. CONCLUSIONS: There are challenges in implementing pro-choice policy in health care systems where it has not traditionally existed. Differences between England and the other countries of the UK were limited in the way choice was offered to patients. A cultural shift is needed to ensure that patients are fully informed by GPs of the choices available to them

    A Content Analysis and Comparison of Two Peaks of Newspaper Reporting During a Suicide Cluster to Examine Implications for Imitation, Suggestion, and Prevention

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    Background: During 2007–2008, media attention focused on a cluster of youth suicides in the UK. There were two peaks (P1, P2) in the volume of newspaper reporting of the deaths. The number of possible suicides was greater than expected at the time of the first peak but not at the time of the second. Aims: To explore any differences in the content of the reporting peaks and to consider implications for imitation and prevention. Method: A content analysis of two peaks of newspaper reporting was conducted. Results: There were 204 articles in P1 (December 27, 2007 to February 19, 2008) and 157 in P2 (February 20, 2008 to March 15, 2008). Four main themes were identified: individual stories; possible causes; features of reporting of the cluster; and educating and informing the public. P1 articles more frequently contained: explicit details of method; photographs of the deceased, and contained more characterization of individuals. Limitations: The focus was on print media, future studies should incorporate online and social media content. Conclusion: The findings provide some support for the hypothesis of a process of suggestion initiated by sensationalist reporting in P1. This contributes to the evidence base of the role of the press in suicide imitation and prevention, highlighting the importance of care when reporting suicides

    The X-ray spectrum of the newly discovered accreting millisecond pulsar IGR J17511-3057

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    We report on an XMM-Newton observation of the accreting millisecond pulsar, IGR J17511-3057. Pulsations at 244.8339512(1) Hz are observed with an RMS pulsed fraction of 14.4(3)%. A precise solution for the P_orb=12487.51(2)s binary system is derived. The measured mass function indicates a main sequence companion with a mass between 0.15 and 0.44 Msun. The XMM-Newton spectrum of the source can be modelled by at least three components, multicoloured disc emission, thermal emission from the NS surface and thermal Comptonization emission. Spectral fit of the XMM-Newton data and of the RXTE data, taken in a simultaneous temporal window, constrain the Comptonization parameters: the electron temperature, kT_e=51(+6,-4) keV, is rather high, while the optical depth (tau=1.34(+0.03,-0.06)) is moderate. The energy dependence of the pulsed fraction supports the interpretation of the cooler thermal component as coming from the accretion disc, and indicates that the Comptonizing plasma surrounds the hot spots on the NS surface, which provide the seed photons. Signatures of reflection, such as a broadened iron K-alpha emission line and a Compton hump at 30 keV ca., are also detected. We derive from the smearing of the reflection component an inner disc radius of ~> 40 km for a 1.4 Msun neutron star, and an inclination between 38{\deg} and 68{\deg}. XMM-Newton also observed two type-I X-ray bursts, probably ignited in a nearly pure helium environment. No photospheric radius expansion is observed, thus leading to an upper limit on the distance to the source of 10 kpc. A lower limit of 6.5 kpc can be also set if it is assumed that emission during the decaying part of the burst involves the whole neutron star surface. Pulsations observed during the burst decay are compatible with being phase locked, and have a similar amplitude, than pre-burst pulsations.Comment: 16 pages, 10 figures, 4 tables, accepted for publication in MNRA

    Effectiveness of Web-Delivered Acceptance and Commitment Therapy in Relation to Mental Health and Well-Being: A Systematic Review and Meta-Analysis

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    BACKGROUND: The need for effective interventions to improve mental health and emotional well-being at a population level are gaining prominence both in the United Kingdom and globally. Advances in technology and widespread adoption of Internet capable devices have facilitated rapid development of Web-delivered psychological therapies. Interventions designed to manage a range of affective disorders by applying diverse therapeutic approaches are widely available. OBJECTIVE: The main aim of this review was to evaluate the evidence base of acceptance and commitment therapy (ACT) in a Web-based delivery format. METHOD: A systematic review of the literature and meta-analysis was conducted. Two electronic databases were searched for Web-delivered interventions utilizing ACT for the management of affective disorders or well-being. Only Randomized Controlled Trials (RCTs) were included. RESULTS: The search strategy identified 59 articles. Of these, 10 articles met the inclusion criteria specified. The range of conditions and outcome measures that were identified limited the ability to draw firm conclusions about the efficacy of Web-delivered ACT-based intervention for anxiety or well-being. CONCLUSIONS: ACT in a Web-based delivery format was found to be effective in the management of depression. Rates of adherence to study protocols and completion were high overall suggesting that this therapeutic approach is highly acceptable for patients and the general public

    Recycling of memory B cells between germinal center and lymph node subcapsular sinus supports affinity maturation to antigenic drift

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    Infection or vaccination leads to the development of germinal centers (GC) where B cells evolve high affinity antigen receptors, eventually producing antibody-forming plasma cells or memory B cells. Here we follow the migratory pathways of B cells emerging from germinal centers (BEM) and find that many BEM cells migrate into the lymph node subcapsular sinus (SCS) guided by sphingosine-1-phosphate (S1P). From the SCS, BEM cells may exit the lymph node to enter distant tissues, while some BEM cells interact with and take up antigen from SCS macrophages, followed by CCL21-guided return towards the GC. Disruption of local CCL21 gradients inhibits the recycling of BEM cells and results in less efficient adaption to antigenic variation. Our findings thus suggest that the recycling of antigen variant-specific BEM cells and transport of antigen back to GC may support affinity maturation to antigenic drift

    StearoylCoA Desaturase-5: A Novel Regulator of Neuronal Cell Proliferation and Differentiation

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    Recent studies have demonstrated that human stearoylCoA desaturase-1 (SCD1), a Δ9-desaturase that converts saturated fatty acids (SFA) into monounsaturated fatty acids, controls the rate of lipogenesis, cell proliferation and tumorigenic capacity in cancer cells. However, the biological function of stearoylCoA desaturase-5 (SCD5), a second isoform of human SCD that is highly expressed in brain, as well as its potential role in human disease, remains unknown. In this study we report that the constitutive overexpression of human SCD5 in mouse Neuro2a cells, a widely used cell model of neuronal growth and differentiation, displayed a greater n-7 MUFA-to-SFA ratio in cell lipids compared to empty-vector transfected cells (controls). De novo synthesis of phosphatidylcholine and cholesterolesters was increased whereas phosphatidylethanolamine and triacylglycerol formation was reduced in SCD5-expressing cells with respect to their controls, suggesting a differential use of SCD5 products for lipogenic reactions. We also observed that SCD5 expression markedly accelerated the rate of cell proliferation and suppressed the induction of neurite outgrowth, a typical marker of neuronal differentiation, by retinoic acid indicating that the desaturase plays a key role in the mechanisms of cell division and differentiation. Critical signal transduction pathways that are known to modulate these processes, such epidermal growth factor receptor (EGFR)Akt/ERK and Wnt, were affected by SCD5 expression. Epidermal growth factor-induced phosphorylation of EGFR, Akt and ERK was markedly blunted in SCD5-expressing cells. Furthermore, the activity of canonical Wnt was reduced whereas the non-canonical Wnt was increased by the presence of SCD5 activity. Finally, SCD5 expression increased the secretion of recombinant Wnt5a, a non-canonical Wnt, whereas it reduced the cellular and secreted levels of canonical Wnt7b. Our data suggest that, by a coordinated modulation of key lipogenic pathways and transduction signaling cascades, SCD5 participates in the regulation of neuronal cell growth and differentiation

    Species Accumulation Curves and Incidence-Based Species Richness Estimators to Appraise the Diversity of Cultivable Yeasts from Beech Forest Soils

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    Background: Yeast-like fungi inhabit soils throughout all climatic zones in a great abundance. While recent estimations predicted a plethora of prokaryotic taxa in one gram of soil, similar data are lacking for fungi, especially yeasts. Methodology/Principal Findings: We assessed the diversity of soil yeasts in different forests of central Germany using cultivation-based techniques with subsequent identification based on rDNA sequence data. Based on experiments using various pre-cultivation sample treatment and different cultivation media we obtained the highest number of yeasts by analysing mixed soil samples with a single nutrient-rich medium. Additionally, several species richness estimators were applied to incidence-based data of 165 samples. All of them predicted a similar range of yeast diversity, namely 14 to 16 species. Randomized species richness curves reached saturation in all applied estimators, thus indicating that the majority of species is detected after approximately 30 to 50 samples analysed. Conclusions/Significance: In this study we demonstrate that robust species identification as well as mathematical approaches are essential to reliably estimate the sampling effort needed to describe soil yeast communities. This approach has great potential for optimisation of cultivation techniques and allows high throughput analysis in the future
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