A mixed-methods investigation into the acceptability, usability and perceived effectiveness of active and passive virtual reality scenarios in managing pain under experimental conditions

Burns patients often suffer excruciating pain during clinical procedures, even with analgesia. Virtual Reality as an adjunct to pharmacological therapy has proved promising in the management of burn pain. More evidence is needed regarding specific forms of Virtual Reality. This mixed-method study examined the impact of active and passive Virtual Reality scenarios in experimental conditions, gathering data relating to user experience, acceptability and effectiveness in managing pain. Four scenarios were developed or selected following a consultative workshop with burns survivors and clinicians. Each was trialled using a cold pressor test with 15 University students. Data were gathered regarding pain threshold and tolerance at baseline and during each exposure. Short interviews were conducted afterwards. The two active scenarios were ranked highest and significantly extended participants pain threshold and tolerance times compared to passive and baseline conditions. Passive scenarios offered little distraction and relief from pain. Active scenarios were perceived to be engaging, challenging, distracting and immersive. They reduced subjective awareness of pain, though suggestions were made for further improvements. Results suggested that active Virtual Reality was acceptable and enjoyable as a means of helping to control experimental pain. Following suggested improvements, scenarios should now be tested in the clinical environment

Grieving Time: A Radio Play

This play called Grieving Time, was written from the personal perspective of Rachel Fehily, author and barrister, in 2020 as a response to the Irish Coronavirus lockdown, with a theme based around how small comforts during the lockdown affected people’s grieving process. It was created through a process of collaboration and rehearsal between the author, actor, and producer within the constraints of the time. It was written in monologue for an actor with whom the author had worked previously. The completed radio play was broadcast on 17 August 2021 by the Irish public service broadcaster, Raidió Teilifís Éireann on the radio programme, Drama on One. It is available as a podcast on https://www.rte.ie/radio/dramaonone/1241306-grieving-time-by-rachel-fehily. The intended effect is to create a sense of communitas among listeners.Esta peça, chamada Grieving Time, foi escrita em 2020 a partir da perspectiva pessoal de Rachel Fehily, autora e advogada,  como resposta ao lockdown irlandês devido o Coronavírus, cujo tema é baseado em como pequenos confortos durante o lockdown afetaram o processo de luto das pessoas. A peça foi criada por meio de um processo de colaboração e ensaio entre a autora, o ator e o produtor considerando as restrições da época. Escrita em forma de monólogo para um ator com quem a autora já havia trabalhado, a peça de rádio foi transmitida em 17 de agosto de 2021 pela emissora irlandesa Raidió Teilifís Éireann no programa de rádio Drama on One. Está disponível como podcast em https://www.rte.ie/radio/dramaonone/1241306-griev-time-by-rachel-fehily. O efeito pretendido é criar um sentimento de communitas entre os ouvintes

An exploration of the aspirations and future orientation of young people from low-income families

Part One: A systematic literature review, in which the available research regarding effective mental health services for low-income, working age adults, is reviewed.Part Two: A qualitative investigation using Interpretative Phenomenological Analysis (IPA) to explore the aspirations and future orientation of adolescents from low-income families. This includes adolescents’ perceptions of their future, influences on aspiration formation and perceived barriers and facilitators.Part Three: Appendices including all relevant documents to the systematic literature review and empirical paper. The appendices also include a reflective statement and epistemological statement

West Nile virus: the Italian national transplant network reaction to an alert in the north-eastern region, Italy 2011

We report four cases of West Nile virus (WNV) transmission following a single multiorgan donation in north-eastern Italy. The transmissions were promptly detected by local transplant centres. The donor had been tested for WNV by nucleic acid amplification test (NAT) prior to transplantation and was negative. There were no detected errors in the nationally implemented WNV safety protocols

Cortical AAV-CNTF gene therapy combined with intraspinal mesenchymal precursor cell transplantation promotes functional and morphological outcomes after spinal cord injury in adult rats

Ciliary neurotrophic factor (CNTF) promotes survival and enhances long-distance regeneration of injured axons in parts of the adult CNS. Here we tested whether CNTF gene therapy targeting corticospinal neurons (CSN) in motor-related regions of the cerebral cortex promotes plasticity and regrowth of axons projecting into the female adult F344 rat spinal cord after moderate thoracic (T10) contusion injury (SCI). Cortical neurons were transduced with a bicistronic adeno-associated viral vector (AAV1) expressing a secretory form of CNTF coupled to mCHERRY (AAV-CNTFmCherry) or with control AAV only (AAV-GFP) two weeks prior to SCI. In some animals, viable or nonviable F344 rat mesenchymal precursor cells (rMPCs) were injected into the lesion site two weeks after SCI to modulate the inhibitory environment. Treatment with AAV-CNTFmCherry, as well as with AAV-CNTFmCherry combined with rMPCs, yielded functional improvements over AAV-GFP alone, as assessed by open-field and Ladderwalk analyses. Cyst size was significantly reduced in the AAV-CNTFmCherry plus viable rMPC treatment group. Cortical injections of biotinylated dextran amine (BDA) revealed more BDA-stained axons rostral and alongside cysts in the AAV-CNTFmCherry versus AAV-GFP groups. After AAV-CNTFmCherry treatments, many sprouting mCherry-immunopositive axons were seen rostral to the SCI, and axons were also occasionally found caudal to the injury site. These data suggest that CNTF has the potential to enhance corticospinal repair by transducing parent CNS populations

Response Parameters for SMS Text Message Assessments Among Pregnant and General Smokers Participating in SMS Cessation Trials.

INTRODUCTION: Despite a substantial increase in use of SMS text messages for collecting smoking-related data, there is limited knowledge on the parameters of response. This study assessed response rates, response speed, impact of reminders and predictors of response to text message assessments among smokers. METHODS: Data were from two SMS cessation intervention trials using clinical samples of pregnant (n = 198) and general smokers (n = 293) sent text message assessments during 3-month cessation programs. Response rates were calculated using data from the host web-server. Changes in response over time, impact of reminders and potential demographic (age, gender, ethnicity, parity, and deprivation) and smoking (nicotine dependence, determination to quit, prenatal smoking history, smoking status at follow-up) predictors of response were analyzed. RESULTS: Mean response rates were 61.9% (pregnant) and 67.8% (general) with aggregated median response times of 0.35 (pregnant) and 0.64 (general) hours. Response rate reduced over time (P = .003) for general smokers only. Text message reminders had a significant effect on response (Ps < .001), with observed mean increases of 13.8% (pregnant) and 17.7% (general). Age (odds ratio [OR] = 0.95, 95% confidence interval [CI] 0.90-1.00) and deprivation (OR = 0.98, 95% CI 0.96-1.00) weakly predicted response among pregnant smokers and nonsmoking status at 4 weeks follow-up (OR = 8.63, 95% CI 3.03-24.58) predicted response among general smokers. CONCLUSIONS: Text message assessments within trial-based cessation programs yield rapid responses from a sizable proportion of smokers, which can be increased using text reminders. While few sources of nonresponse bias were identified for general smokers, older and more deprived pregnant women were less likely to respond. IMPLICATIONS: This study demonstrates that most pregnant and general smokers enrolled in a cessation trial will respond to a small number of questions about their smoking sent by text message, mostly within 1 hour of being sent the assessment text message. For those who do not initially respond, our findings suggest that 24- and 48-hour text message reminders are likely to increase response a small but meaningful amount. However, older age and higher deprivation among pregnant smokers and relapse among general smokers is likely to reduce the chance of response.The MiQuit feasibility trial was funded by Cancer Research UK (CR-UK) grant number C1345/A5809. The iQuit in Practice trial was funded by the National Institute for Health Research (NIHR) School for Primary Care Research (SPCR).This is the final version of the article. It first appeared from Oxford University Press via http://dx.doi.org/10.1093/ntr/ntv26

Lower cardiorespiratory fitness contributes to increased insulin resistance and fasting glycaemia in middle-aged South Asian compared with European men living in the UK

AIMS/HYPOTHESIS: This study aimed to determine the extent to which increased insulin resistance and fasting glycaemia in South Asian men, compared with white European men, living in the UK, was due to lower cardiorespiratory fitness (maximal oxygen uptake [[Formula: see text]]) and physical activity. METHODS: One hundred South Asian and 100 age- and BMI-matched European men without diagnosed diabetes, aged 40–70 years, had fasted blood taken for measurement of glucose concentration, HOMA-estimated insulin resistance (HOMA(IR)), plus other risk factors, and underwent assessment of physical activity (using accelerometry), [Formula: see text], body size and composition, and demographic and other lifestyle factors. For 13 South Asian and one European man, HbA(1c) levels were >6.5% (>48 mmol/mol), indicating potential undiagnosed diabetes; these men were excluded from the analyses. Linear regression models were used to determine the extent to which body size and composition, fitness and physical activity variables explained differences in HOMA(IR) and fasting glucose between South Asian and European men. RESULTS: HOMA(IR) and fasting glucose were 67% (p < 0.001) and 3% (p < 0.018) higher, respectively, in South Asians than Europeans. Lower [Formula: see text], lower physical activity and greater total adiposity in South Asians individually explained 68% (95% CI 45%, 91%), 29% (11%, 46%) and 52% (30%, 80%), respectively, and together explained 83% (50%, 119%) (all p < 0.001) of the ethnic difference in HOMA(IR). Lower [Formula: see text] and greater total adiposity, respectively, explained 61% (9%, 111%) and 39% (9%, 76%) (combined effect 63% [8%, 115%]; all p < 0.05) of the ethnic difference in fasting glucose. CONCLUSIONS/INTERPRETATION: Lower cardiorespiratory fitness is a key factor associated with the excess insulin resistance and fasting glycaemia in middle-aged South Asian, compared with European, men living in the UK. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00125-013-2969-y) contains peer-reviewed but unedited supplementary material, which is available to authorised users