Search

In this exploratory study we aim to understand whether metaphor plays a role in re-authoring narratives when coachees are experiencing process posttraumatic growth (PTG). Recognising the post-trauma phase of their life, nine participants who utilised the modality of coaching whilst in trauma recovery were interviewed using semi-structured questions, the data was analysed using inductive thematic analysis. Four key themes emerged from the results indicating metaphor usage is a common factor in re-authoring post-trauma: awareness of past-trauma and a need for reauthoring; an expression for change; the PTG framework created a coherent narrative of PTG in the present; and both coaching and metaphor created a coherent narrative of self and life in the present.

Abstract Cyclization provides a general strategy for improving the proteolytic stability, cell membrane permeability and target binding affinity of peptides. Insertion of a stable, non-reducible linker into a disulphide bond is a commonly used approach for cyclizing phage-displayed peptides. However, among the vast collection of cysteine reactive linkers available, few provide the selectivity required to target specific cysteine residues within the peptide in the phage display system, whilst sparing those on the phage capsid. Here, we report the development of a cyclopropenone-based proximity-driven chemical linker that can efficiently cyclize synthetic peptides and peptides fused to a phage-coat protein, and cyclize phage-displayed peptides in a site-specific manner, with no disruption to phage infectivity. Our cyclization strategy enables the construction of stable, highly diverse phage display libraries. These libraries can be used for the selection of high-affinity cyclic peptide binders, as exemplified through model selections on streptavidin and the therapeutic target αvβ3.

The relationship of heavy alcohol consumption (HAC) and smoking to mortality in those with CHD, and mechanisms through which these effects are elicited are not clear. In order to improve our understanding, we examined the relationship of Alcohol T-Scores (ATS), an epigenetic biomarker of chronic HAC, and cg05575921 methylation, a biomarker of smoking intensity, with all-cause mortality and degree of coronary artery obstruction in a cohort of 217 subjects admitted for CHD-related acute coronary syndrome (ACS). We found that 65% of the subjects had ATS values indicative of chronic HAC. ATS values, but not cg05575921 values, were significantly associated (p

Currently, clinicians use their judgement and indices such as the Prediction of Alcohol Withdrawal Syndrome Scale (PAWSS) to determine whether patients are admitted to hospitals for consideration of withdrawal syndrome (AWS). However, only a fraction of those admitted will experience severe AWS. Previously, we and others have shown that epigenetic indices, such as the Alcohol T-Score (ATS), can quantify recent alcohol consumption. However, whether these or other alcohol biomarkers, such as carbohydrate deficient transferrin (CDT), could identify those at risk for severe AWS is unknown. To determine this, we first conducted genome-wide DNA methylation analyses of subjects entering and exiting alcohol treatment to identify loci whose methylation quickly reverted as a function of abstinence. We then tested whether methylation at a rapidly reverting locus, cg07375256, or other existing metrics including PAWSS scores, CDT levels, or ATS, could predict outcome in 125 subjects admitted for consideration of AWS. We found that PAWSS did not significantly predict severe AWS nor seizures. However, methylation at cg07375256 (ZSCAN25) and CDT strongly predicted severe AWS with ATS (p

Abstract Designing conservation interventions for rare species can be hindered by a lack of relevant data. Local ecological knowledge (LEK) has potential to provide rapidly collected, cost‐effective data across large spatio‐temporal scales, but has rarely been used as a source of conservation‐relevant information for the Asian Songbird Crisis. The Blue‐crowned Laughingthrush (Pterorhinus courtoisi; BCLT) is a Critically Endangered passerine found only in southeastern China. It is unclear why the species' breeding range and global population are extremely small, as it occurs in human‐occupied forest‐agricultural landscapes similar to surrounding environments across southern China. We conducted systematic range‐wide interviews on BCLT (n = 519) to collect novel information on the species' temporal and spatial distribution, and on potential human activities and landscape changes associated with its presence or absence. Recognition of BCLT was moderate (45.0% of respondents reported sightings), with sightings within the previous 18 months across the study area, within and beyond their known distribution. Over half of known breeding villages were confirmed by LEK data, and nesting was reported from two villages with no previous breeding records. BCLT trapping was reported across the study landscape, mostly from the last decade and associated with trappers from urban centres. BCLT trapping and lack of fengshui forest were associated with sites where BCLTs did not breed. Breeding sites were associated with increases in vegetable gardens over respondents' lifetimes, and other sites within the species' range were associated with decreases in bush/scrub. We demonstrate that LEK can identify potential threats, new breeding sites and landscape changes correlated with species presence or absence for threatened birds affected by the Asian songbird crisis. This study provides the first evidence of ongoing trapping as a threat to BCLT, and remedial measures are urgently required across the region. Read the free Plain Language Summary for this article on the Journal blog.

This review investigates the relevance of socio-cognitive mindfulness (Langer, 1989) to wellbeing coaching by systematically synthesising the evidence to understand how socio-cognitive mindfulness interventions work. The search yielded 2,867 peer-reviewed studies with twelve papers meeting the eligibility criteria. The interventions induced socio-cognitive mindfulness with non-clinical adults via one or more psychological processes to achieve intrapersonal, interpersonal and environmental wellbeing. Six of the studies employed exercises to produce boosts in wellbeing, whilst six conducted extended programmes, of which three demonstrated sustained wellbeing improvements. The findings indicate that socio-cognitive mindfulness could provide valuable insights for practitioners and synergistic benefits for wellbeing coaching.

This research investigates an embodied metaphor-based positive psychology coaching intervention created as a method to transform perceptions and generate change. Six participants were recruited to work with the metaphor intervention; data was collected via participant journals and semi-structured interviews, with analysis completed using interpretative phenomenological analysis methodology. Results indicate that this metaphor process led to significant breakthroughs for participants under three themes: meta-position provides rationality and relieves pressure; agency prompts transformation from contractive to expansive energy; and insight is gained about one’s self and situation. This study provides evidence for using metaphor as an effective coaching or positive psychology intervention.

Background and purpose: The Swedish Lymphoma Register (SLR) was initiated in the year 2000 with the aim to monitor quality of care in diagnostics, treatment and outcome of all lymphomas diagnosed nationally among adults. Here, we present the first systematic validation of SLR records as a basis for improved register quality and patient care. Patients and methods: We evaluated timeliness and completeness of register records among patients diagnosed with lymphoma in the SLR (n = 16,905) compared with the National Cancer Register for the period 2013–2020. Comparability was assessed through evaluation of coding routines against national and international guidelines. Accuracy of 42 variables was evaluated through re-abstraction of data from medical records among 600 randomly selected patients diagnosed in 2016–2017 and treated across all six Swedish healthcare regions. Results: Completeness was high, >95% per year for the period 2013–2018, and >89% for 2019–2020 compared to the National Cancer Register. One in four patients was registered within 3 months, and 89.9% within 2 years of diagnosis. Registration instructions and coding procedures followed the prespecified guidelines. Missingness was generally low (80% for 24/34 variables), especially for treatment-related data (>80% for 17/19 variables). Interpretation: Completeness and accuracy are high in the SLR, while timeliness could be improved. Finetuning of variable registration guided by this validation can further improve reliability of register reports and advance service to lymphoma patients and health care in the future.

Abstract Background There is a workforce shortage in the children’s hospice sector, but there has been little research on the specific challenges of working in this setting and on how these challenges might be alleviated. To identify appropriate interventions to improve staff wellbeing, the drivers of wellbeing in children’s hospices need to be known and measured. This paper reports on the development of two measures, one for work-related rewards and one for work-related stressors, for use in children’s hospice care teams. Methods A mixed-methods, four-stage study; the first three phases focused on the development of the scales, and the last stage focused on the validation of the scales. Participants of all stages were children’s hospice care team staff members in the UK. Stage 1: survey assessing the relevance and comprehensiveness of the original scale items (N = 60); Stages 2 (focus groups; N = 16) and 3 (cognitive interviews; N = 14) to assess content validity; Stage 4: UK-wide survey (N = 414) to validate the final version of the new, children’s hospice-specific scales using Rasch Analysis (RA) and Confirmatory Factor Analysis (CFA). Results Due to poor fitting indices shown in the results from the RA, five items (out of 36) were removed from the new rewards scale used in the UK-wide survey and 20 (out of 62) were removed from the new stressors scale. CFA also supported the removal of the items and showed a one-factor structure for the rewards scale and a three-factor structure for the stressors scale were adequate—the sub-scales for the stressors scale related to caring for an ill or dying child (“Child” sub-scale), working with parents and families (“Parent” sub-scale), and stressors related to organisational factors, such as team conflict and workload (“Organisation” sub-scale). Conclusions Both of the new scales showed good psychometric properties and can be useful in clinical settings and research to assess the perceived intensity of the work-related rewards and stressors for children’s hospice staff.

Abstract Background Provision of and access to paediatric end-of-life care is inequitable, but previous research on this area has focused on perspectives of health professionals in specific settings or children with specific conditions. This qualitative study aimed to explore regional perspectives of the successes, and challenges to the equitable coordination and delivery of end-of-life care for children in the UK. The study provides an overarching perspective on the challenges of delivering and coordinating end-of-life care for children in the UK, and the impact of these on health professionals and organisations. Previous research has not highlighted the successes in the sector, such as the formal and informal coordination of care between different services and sectors. Methods Semi-structured interviews with Chairs of the regional Palliative Care Networks across the UK. Chairs or co-Chairs (n = 19) of 15/16 Networks were interviewed between October-December 2021. Data were analysed using thematic analysis. Results Three main themes were identified: one standalone theme (“Communication during end-of-life care”); and two overarching themes (“Getting end-of-life services and staff in the right place”, with two themes: “Access to, and staffing of end-of-life care” and “Inconsistent and insufficient funding for end-of-life care services”; and “Linking up healthcare provision”, with three sub-themes: “Coordination successes”, “Role of the networks”, and “Coordination challenges”). Good end-of-life care was facilitated through collaborative and network approaches to service provision, and effective communication with families. The implementation of 24/7 advice lines and the formalisation of joint-working arrangements were highlighted as a way to address the current challenges in the specialism. Conclusions Findings demonstrate how informal and formal relationships between organisations and individuals, enabled early communication with families, and collaborative working with specialist services. Formalising these could increase knowledge and awareness of end of life care, improve staff confidence, and overall improve professionals’ experiences of delivering care, and families’ experiences of receiving it. There are considerable positives that come from collaborative working between different organisations and sectors, and care could be improved if these approaches are funded and formalised. There needs to be consistent funding for paediatric palliative care and there is a clear need for education and training to improve staff knowledge and confidence.

Not available.

Abstract Workplaces can be sources of both stress and support, affecting employees' mental health and productivity. Yet, little research has investigated variability in workplace risk factors for poor mental health in conservation. We aimed to explore how patterns of psychological distress—a state of emotional disturbance—and associated workplace risk factors vary between conservation job roles. Working with three case study organizations in India, South Africa, and Cambodia, we surveyed 280 field‐based, office‐based, and research staff. Moderate or severe psychological distress was reported by 28.9%. Field‐based practitioners reported a greater imbalance between workplace efforts and rewards (0.35 standard deviation (SD), 95% credibility interval (CI) 0.03–0.67) than their colleagues, which was associated with greater psychological distress (0.24 SD, 95% CI 0.10–0.39). After controlling for this mediated relationship, researchers reported greater psychological distress than field‐based practitioners (0.37 SD, 95% CI 0.02–0.72). However, when accounting for all direct and indirect effects, there was no overall difference in distress between roles. Employers, funders, professional societies, and other institutions seeking to support conservationists' mental health should understand and offer support tailored to role‐specific challenges. Doing so might enhance conservationists' wellbeing while strengthening their ability to reverse global nature loss.

The tropics are a stronghold for diurnal raptor species, with 28% of these species found in South America, and Neotropical raptors being a particularly understudied group. In this study, we conducted a riverine survey to understand the seasonal distribution patterns of the raptors in the Área de Conservación Regional Comunal Tamshiyacu Tahuayo reserve in north-eastern Peru. In both the dry and rainy seasons, we surveyed five 4 km transects along the Tahuayo river at three different times of day (early/late morning and afternoon), while moving at 4–5 km/hr in a motor boat. A total of 928 individuals were sighted across 26 species of diurnal raptors. Seven of these species showed differences in abundance between the dry and rainy seasons. We compared the results from this study to that of a rapid assessment conducted 13 years prior, the only major avian survey conducted in the reserve, and found nine new documented raptor species for the reserve. The differences in the findings of this study and the previous one conducted in the reserve display the value of and need for repeated long-term monitoring in areas of high biodiversity to allow a more thorough understanding of the communities found there. [ABSTRACT FROM AUTHOR]

The relationship of heavy alcohol consumption (HAC) and smoking to mortality in those with CHD, and mechanisms through which these effects are elicited are not clear. In order to improve our understanding, we examined the relationship of Alcohol T-Scores (ATS), an epigenetic biomarker of chronic HAC, and cg05575921 methylation, a biomarker of smoking intensity, with all-cause mortality and degree of coronary artery obstruction in a cohort of 217 subjects admitted for CHD-related acute coronary syndrome (ACS). We found that 65% of the subjects had ATS values indicative of chronic HAC. ATS values, but not cg05575921 values, were significantly associated (p < 0.02) with subsequent proband death (total of 28 deaths) with a Cox Proportional Hazards model showing a slightly larger effect of ATS levels than age on all-cause mortality survival (overall model, p < 0.003). Subjects in the highest decile of ATS scores had a 2.4-fold increase in the risk for mortality as compared to those in the lowest decile. In contrast, cg05575921 methylation (p < 0.003) but not ATS scores, were significantly inversely associated with degree of obstruction. Only 2 of the 217 subjects were referred for treatment for either smoking or drinking. We conclude that HAC is an underappreciated driver of CHD-related mortality, that those with ACS who smoke are much less likely to have significant obstruction upon cardiac imaging and that substance use treatment may be underutilized in those with CHD. [ABSTRACT FROM AUTHOR]

Currently, clinicians use their judgement and indices such as the Prediction of Alcohol Withdrawal Syndrome Scale (PAWSS) to determine whether patients are admitted to hospitals for consideration of withdrawal syndrome (AWS). However, only a fraction of those admitted will experience severe AWS. Previously, we and others have shown that epigenetic indices, such as the Alcohol T-Score (ATS), can quantify recent alcohol consumption. However, whether these or other alcohol biomarkers, such as carbohydrate deficient transferrin (CDT), could identify those at risk for severe AWS is unknown. To determine this, we first conducted genome-wide DNA methylation analyses of subjects entering and exiting alcohol treatment to identify loci whose methylation quickly reverted as a function of abstinence. We then tested whether methylation at a rapidly reverting locus, cg07375256, or other existing metrics including PAWSS scores, CDT levels, or ATS, could predict outcome in 125 subjects admitted for consideration of AWS. We found that PAWSS did not significantly predict severe AWS nor seizures. However, methylation at cg07375256 (ZSCAN25) and CDT strongly predicted severe AWS with ATS (p < 0.007) and cg07375256 (p < 6 × 10–5) methylation also predicting AWS associated seizures. We conclude that epigenetic methods can predict those likely to experience severe AWS and that the use of these or similar Precision Epigenetic approaches could better guide AWS management. [ABSTRACT FROM AUTHOR]

During Britain's conflicts between 1793 and 1815, the Royal Navy changed markedly. New classes of smaller warships were introduced, with numerous vessels built to Admiralty (King's Yard) designs in private shipyards rather than the Royal Dockyards. Many were sloops-of-war, flush-decked and unrated vessels, carrying 20 guns or fewer, that proved versatile in operations around the world. After 1815, the size of the fleet was reduced. Initially many vessels were kept in reserve, but eventually most were sold for mercantile service or breaking, some of the latter also then being resold for merchant use. These vessels proved attractive to long-established whaling owners and new entrants to the whaling trade alike. Such warship-to-whaleship transitions are examined through vessels entering the British southern whale fishery in the post-Napoleonic period between 1815 and 1845. [ABSTRACT FROM AUTHOR]

Following the French Revolutionary, American and Napoleonic wars between 1793 and 1815, many smaller British warships were sold to merchant ship owners directly or to shipyards for breaking or resale. Identifying changes from naval to commercial employment is not always straightforward and the availability or accuracy of a vessel's history not always assured. One yacht built at Deptford in 1785 with Danish royal connections and then a British naval career presents such questions. Sold out of naval service in 1818, ostensibly for breaking, it is argued that the former yacht was not broken up but rebuilt and resold to become a whaleship from 1820 to about 1837. The vessel provides an unusual case study of a transition from royal to naval service and then into mercantile employment. [ABSTRACT FROM AUTHOR]

While completing a science test and science survey, 155 high school students wore a biometric wristband (measuring electrodermal activity; EDA) and self-reported their science self-efficacy and science anxiety. Adopting a challenge-threat appraisal perspective and latent profile analysis, we explored how students were psychologically (self-efficacy, anxiety) and physiologically (EDA) oriented to science. We identified three groups (profiles), representing different challenge-threat profiles. The largest group was the 'composed challenge-and-threat' group (modest EDA, average anxiety, average self-efficacy). The next largest was the 'aroused high-threat' group (elevated EDA, elevated anxiety, low self-efficacy). The third represented 'composed high-challenge' students (modest EDA, elevated self-efficacy, low anxiety). The aroused high-threat group scored significantly lower than composed high-challenge and composed challenge-and-threat groups in science test performance and flow. Notably, the composed high-challenge and composed challenge-and-threat groups did not significantly differ in test performance; however, the composed high-challenge group was significantly higher in flow than the composed challenge-and-threat group.

Background: Patient and Public Involvement (PPI) is an important component of healthcare research. Conducting PPI within paediatric palliative care research requires specific ethical and practical considerations. Regular reviews of PPI activity are important. Aim: To evaluate a paediatric palliative care research centre's PPI activity to determine what went well, or less well; and how future activities can be improved. Design: Two stage evaluation: first a review of PPI study logs; second a qualitative exploration using a survey, structured interviews and a focus group. Data were analysed thematically. Settings/participants: Parents of children with life-limiting conditions, bereaved parents and researchers, all engaged in PPI activity within a paediatric palliative care research centre. Findings: The review of PPI logs for 15 studies highlighted the crucial role of funding in enabling PPI throughout the research. Eight parents completed the survey, 4 parents were interviewed and 12 researchers participated in a focus group. Three themes were developed: Clarity of processes and purpose; balanced relationships created a safe space; and mutual respect and value for PPI. These themes highlight what is working well within the Centre's approach to PPI and the opportunities to improve. Conclusions: To undertake meaningful PPI in paediatric palliative care research, adequate time and resources are required. Roles, processes and expectations must be explicitly agreed. Establishing relationships ensures trust and enables authenticity and vulnerability. In addition to improving research, PPI has personal benefits for researchers and parents. The evaluation led to the development of a 'route map' for establishing an impactful PPI group for paediatric palliative care research. [ABSTRACT FROM AUTHOR]

Background: Although child mortality has decreased over the last few decades, around 4,500 infants and children die in the UK every year, many of whom require palliative care. There is, however, little evidence on paediatric end-of-life care services. The current National Institute for Health and Care Excellence (NICE) guidance provides recommendations about what should be offered, but these are based on low quality evidence. The ENHANCE study aims to identify and investigate the different models of existing end-of-life care provision for infants, children, and young people in the UK, including an assessment of the outcomes and experiences for children and parents, and the cost implications to families and healthcare providers. Methods: This mixed methods study will use three linked workstreams and a cross-cutting health economics theme to examine end-of-life care models in three exemplar clinical settings: infant, children and young adult cancer services (PTCs), paediatric intensive care units (PICUs), and neonatal units (NNUs). Workstream 1 (WS1) will survey current practice in each setting and will result in an outline of the different models of care used. WS2 is a qualitative comparison of the experiences of staff, parents and patients across the different models identified. WS3 is a quantitative assessment of the outcomes, resource use and costs across the different models identified. Discussion: Results from this study will contribute to an understanding of how end-of-life care can provide the greatest benefit for children at the end of their lives. It will also allow us to understand the likely benefits of additional funding in end-of-life care in terms of patient outcomes.

Abstract Background Consistent evidence suggests that children’s palliative care is not equitable and managed clinical networks (MCNs) have been recommended as a solution. This study explored the perspectives of health professionals involved in the development of a children’s palliative care MCN, with an aim to identify barriers and enablers of successful implementation. Methods Thematic analysis of semi-structured interviews and focus groups with 45 healthcare staff with a role in developing the MCN or in the delivery of children’s palliative care (September 2019–March 2020). Results The study explored health professionals’ perceptions of the MCN features that had helped to formalise governance processes, establish training and networking opportunities, standardise practice, and improve collaboration between organisations. These include the funded MCN co-ordinator, committed individuals who lead the MCN, and a governance structure that fosters collaboration. However, the MCN’s development was impeded by cross-cutting barriers including limited funding for the MCN and children’s palliative care more generally, no shared technology, lack of standards and evidence base for children’s palliative care, and shortage of palliative care staff. These barriers impacted on the MCN’s ability to improve and evaluate palliative care provision and affected member engagement. Competing organisational priorities and differences between NHS and non-NHS members also impeded progress. Training provision was well received, although barriers to access were identified. Conclusions Key features of children’s palliative care can act as barriers to developing a managed clinical network. Managing expectations and raising awareness, providing accessible and relevant training, and sharing early achievements through ongoing evaluation can help to sustain member engagement, which is crucial to a network’s success.

Abstract Shifting baseline syndrome (SBS) describes a persistent downgrading of perceived ‘normal’ environmental conditions with every sequential generation, leading to under‐estimation of the true magnitude of long‐term environmental change on a global scale. The presence of SBS should be considered when local ecological knowledge and participatory techniques are involved in conservation target‐setting. However, despite increasing recognition of the phenomenon, there is little empirical evidence for SBS. Here we provide evidence of SBS, and the first empirical investigation of the impacts of SBS on public perceptions of conservation need. Large‐scale online questionnaires were used to collect public perceptions of long‐term biological change regarding 10 UK bird species, as well as demographic information and measures of knowledge and experience of the local environment (n = 330). A paired data approach compared social perceptions to a large‐scale longitudinal biological dataset. Using information theoretic and model selection techniques, we estimate the relative importance of multiple demographic, social and psychological predictors of SBS. We provide a framework for investigating evidence of SBS and its impacts on perceptions of conservation need for species in decline. Evidence of generational amnesia was found as an age‐related difference in perceptions of past ecological conditions. The perceptions of older participants had significantly higher agreement with biological data than the perceptions of younger participants. Our results therefore support the expectation that younger, less experienced people are less aware of historical ecological conditions and show greater evidence of SBS. We also present evidence of a negative impact of SBS on future conservation, as older people were more likely than younger people to perceive a greater need for conservation action for three declining species. Our research supports the need to encourage greater intergenerational communication and increase experience of local nature. Discovering evidence of SBS in public perceptions of species experienced within everyday life demonstrates SBS as a pervasive social issue with the potential to impact public perceptions of local nature. A free Plain Language Summary can be found within the Supporting Information of this article.

Abstract In the face of unprecedented biodiversity loss, the belief that conservation goals can be met could play an important role in ensuring they are fulfilled. We asked conservationists how optimistic they felt about key biodiversity outcomes over the next 10 years; 2341 people familiar with conservation in 144 countries responded. Respondents expressed optimism that enabling conditions for conservation would improve but felt pressures would continue, and the state of biodiversity was unlikely to get better. Respondents with greater general optimism about life, at early‐career stages, and working in practice and policy (compared to academia) reported higher conservation optimism. But most of our biodiversity and conservation status indicators were not associated with conservation optimism. Unbounded optimism without appropriate action would be misguided in the face of growing threats to biodiversity. However, supporting those struggling to see the light at the end of the tunnel could help sustain efforts to overcome these threats.

The illegal wildlife trade represents an urgent conservation challenge, but measuring, understanding, and designing interventions to address it is a complex task. As some of the world's most illegally trafficked wild mammals, pangolins are regularly observed in the illegal wildlife trade, but little is known of the intricacies of the trade at local levels, particularly for lesser-known species such as the Philippine pangolin (Manis culionensis). This research represents the first range-wide study to concurrently document local use and trade of the Philippine pangolin across Palawan Province, Philippines, and provides new information on trade actors, dynamics, and the conditions that help to facilitate this industry. The study was carried out across 18 Palawan municipalities, covering all mainland municipalities, Araceli Island, and the Calamianes Island group. A mixed methods approach was used, combining 1,277 bean count surveys to investigate consumption and hunting levels, alongside 59 in-depth key informant interviews to better understand trade logistics and dynamics. Our results suggest that local use of the species is geographically widespread, but trade hubs were most frequently reported from northern municipalities. Several enabling conditions help facilitate trade across the province, and our data suggest the species may be contributing to the international pangolin trade at levels considerably higher than seizure records indicate.