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iMAgery focused therapy for PSychosis (iMAPS-2): an assessor-blind feasibility randomised controlled clinical trial
No full textBackground and Hypothesis:
Intrusive mental images and negative schematic beliefs have been identified as maintenance and possible causal factors for some psychotic experiences, with limited
focus in existing therapies in psychosis. Our primary aim was to assess the feasibility and acceptability of undertaking a randomised controlled trial (RCT) of a novel, imagery focused psychological therapy for psychosis (iMAPS).
Study Design: An assessor-blind RCT (iMAPS-2). Participants who were help seeking; with hallucinations or delusions, who reported distressing intrusive mental imagery were eligible to take part. Participants were randomly assigned (2:1) to receive 12 sessions of iMAPS therapy plus standard care or treatment as usual (TAU). Assessments were undertaken at 0, 16 and 28 weeks. The primary feasibility outcomes were recruitment target, retention at 16 week follow up and number of therapy sessions attended.
Study Results: The trial recruitment was 100% of target (45 participants). The study had a high rate of retention of 80% (36 participants) at 16-week primary endpoint, a high rate of adherence to the imagery focused therapy (77%) and positive qualitative feedback. There were two serious adverse events in the iMAPS therapy arm deemed unrelated to treatment and zero in the TAU group.
Conclusions: This is the largest trial to date of imagery focused therapy for psychosis, demonstrating it is safe. An adequately powered clinical and cost effectiveness trial is warranted to provide an estimate of the effects of the iMAPS therapy.
Trial Registration ISRCTN: 8115078
Comparing CO2 Laser and Microdrill in Primary Stapedotomy: A Systematic Review and Meta-Analysis of Postoperative Hearing Outcomes and Complications
Get PDFObjective: The gold-standard treatment of otosclerosis is stapedectomy. Recent surgical advancements have led to the use of two approaches for stapedectomy: CO₂ laser and microdrill-assisted stapedotomy. There is limited data on the comparison of both interventions. This study aims to provide an update on evidence-based medicine on the use of CO₂ laser and microdrill in stapedotomy. Materials and methods: A systematic review and meta-analysis were conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines and an electronic search was conducted to identify studies comparing CO₂ laser versus microdrill for stapedectomy. Postoperative hearing outcomes and the rates of sensorineural hearing loss (SNHL) were identified as primary outcomes. Secondary outcomes included postoperative complications such as vertigo and abnormal taste sensation. The analysis was based on fixed or random-effects modelling. Results: Four studies enrolling 1540 patients were identified. Postoperative hearing outcomes (Odds Ratio [OR]= 1.23, P=0.1), SNHL (OR= 0.8, P=0.74), and abnormal taste sensation post-operatively (OR= 0.84, P=0.58) were not significantly different between both interventions. However, a significant difference was found between both groups for post-operative vertigo, showing a higher rate for the microdrill group (OR= 2.54, P=0.02). Conclusion: In conclusion, CO₂ laser and microdrill are both effective procedures for stapedectomy, as they both produced comparable outcomes in post-operative hearing outcomes and SNHL. However, microdrill had higher rates of post-operative vertigo, possibly indicating that the CO₂ laser is a slightly more preferable option
Specific visual expertise reduces susceptibility to visual illusions
Get PDFExtensive exposure to specific kinds of imagery tunes visual perception, enhancing recognition and interpretation abilities relevant to those stimuli (e.g. radiologists can rapidly extract important information from medical scans). For the first time, we tested whether specific visual expertise induced by professional training also affords domain-general perceptual advantages. Experts in medical image interpretation (n = 44; reporting radiographers, trainee radiologists, and certified radiologists) and a control group consisting of psychology and medical students (n = 107) responded to the Ebbinghaus, Ponzo, Müller-Lyer, and Shepard Tabletops visual illusions in forced-choice tasks. Our results show that medical image experts were significantly less susceptible to all illusions except for the Shepard Tabletops, demonstrating superior perceptual accuracy. These findings could possibly be attributed to a stronger local processing bias, a by-product of learning to focus on specific areas of interest by disregarding irrelevant context in their domain of expertise
Effects of Peppermint (Mentha piperita L.) Oil in Cardiometabolic Outcomes in participants with pre and stage 1 hypertension: Protocol for a Placebo Randomized Controlled Trial.
Get PDFBackground
Hypertension is the predominant risk factor for cardiovascular disease morbidity and mortality, with significant healthcare utilization and expenditure. Pharmaceutical management is habitually adopted; although its long-term effectiveness remains ambiguous, and accompanying adverse effects are disquieting. Peppermint owing to its abundance of menthol and flavonoids, possesses a range of potential hypertensive benefits.
Rationale:
Our previous trial has shown that peppermint is able to mediate significant improvements in systolic blood pressure in healthy individuals. But there has yet to be any randomized placebo-controlled studies, examining the efficacy of peppermint supplementation in hypertensive individuals
Objective: This study proposes a placebo randomized controlled trial, exploring the effects of daily peppermint oil supplementation on outcomes pertinent to hypertensive disease in individuals with pre and stage 1 hypertension.
Methods and analyses:
This 20-day, parallel randomized, placebo-controlled trial will recruit 40 individuals, assigned to receive either 100μL per day of either Peppermint oil or a peppermint flavoured placebo. The primary trial outcome will be the between-group difference in systolic blood pressure from baseline to post-intervention. Secondary outcome measurements will be between-group differences in anthropometric, haematological, diastolic blood pressure/ resting heart rate, psychological wellbeing, and sleep efficacy indices. Statistical analysis will be conducted on an intention-to-treat basis using linear mixed effects models to contrast differences in the changes from baseline to 20-days between the two trial arms.
Ethics and dissemination:
Ethical approval has been granted by the University of Central Lancashire (HEALTH 01074) and the study has formally been registered as a trial (NCT05561543). Dissemination of the trial findings will be through publication in a peer-reviewed journal.
Trial registration: ClinicalTrials.gov NCT05561543
Ethics: HEALTH 0107
Evaluating Immersion in Digital Video Using EEG and Subjective Measures: A Pilot Study
No full textImmersion in digital video refers to the degree to which digital content engages and absorbs viewers. Today, viewers primarily consume digital video online. Despite ample bandwidth availability, network disruptions (e.g., congestion and outages) can degrade quality and interrupt the viewing experience, thereby breaking immersion. In a pilot study, we evaluated viewer immersion while watching digital video content on two streaming services (IPTV and HLS) delivered via conventional IP and our POINT network under regular and exceptional network conditions (congestion and link failures). We used Electroencephalography (EEG) and user interviews to gather data. EEG data indicate that videos streamed through POINT create a more immersive experience in terms of presence, sensory engagement, realism, and detail compared to conventional IP, although the impact varies by service. Interview data corroborate the EEG measures but indicate that POINT’s impact was independent of the specific service used (IPTV or HLS). These findings suggest that POINT enhances viewer immersion over traditional IP networks, particularly under challenging network conditions, but the impact may be service-specific. We plan to conduct a follow-up study with a larger user group and incorporate additional sensors (emotion analysis and eye-tracking) to more comprehensively measure viewers’ emotional and cognitive states under each experimental condition
THE IMPACT OF COVID-19 LOCKDOWNS ON PRE-COMPETITION ANXIETY LEVELS IN PROFESSIONAL AND AMATEUR ATHLETES
Get PDFPurpose: The purpose of this study was to investigate and compare professional and amateur athletes’ pre-competition anxiety levels using a CSAI-2 scale which includes three subscales; cognitive state anxiety, somatic state anxiety and self-confidence before and after Covid-19 lockdown. The hypotheses of this research were that Covid-19 lockdown would have a significant effect on athletes’ pre-competition anxiety levels.
Methods: 57 athletes (41 males, 16 females) from 10 different countries were provided with an online Competitive State Anxiety Inventory-2 (CSAI-2) questionnaire, which included 60 questions in order to collect data about athletes’ cognitive state anxiety, somatic state anxiety and self-confidence levels before and after Covid-19 lockdown.
Results: It was determined that the differences between the scores of Cognitive state anxiety, Somatic state anxiety and Self-confidence subscales of the athletes included in CSAI-2 before and after Covid19 lockdown are found to be statistically significant (p<0.05).
Conclusions: While the Cognitive state anxiety and Somatic state anxiety scores of both amateur and professional athletes increased after Covid-19 lockdown, their Self-confidence scores decreased. Their age, gender, level of education, playing an individual sport or a team sport or being an elite or non-elite athlete did not have an effect on increased pre-competition anxiety levels
Interview
Get PDFJulian Manley has been an active member of CPA for more than a decade. He has served on its Board for several years and had a vital influence over it becoming a Community Benefit Society, co-owned by its members. This reflected Julian’s longstanding interest in sociocratic and cooperative principles of governance, an interest first triggered through his involvement with Mondragon in the Basque Country in Spain, and more recently manifest through being one of the key figures involved in the Preston Model of Community Wealth Building development in the UK.
In this interview with Paul Hoggett, Julian describes how his involvement in another social innovation, Social Dreaming, brought about his connection to Mondragon, a massive network involving more than 70,000 worker cooperative members producing everything from high tech goods to consumer durables. Later, through this connection, Julian was able to contribute to the seeding of a similar initiative in Preston. The Preston Model offered a very different model of economic and social regeneration, one which flew in the face of neoliberal globalisation, and it quickly caught the eye of leftist policy makers in various parts of the UK. The connection between this model and green approaches to community regeneration is explored in the latter part of the interview
Tourism, Place Branding, and Consumer Behaviour
No full textGiven the symbolic significance of places such as nations, regions, cities, and gated communities, the ideas of brands and branding are being applied to them in recent times. For example, nation branding is becoming common especially as countries compete among themselves for resources and opportunities like investment inflows and skilled professionals. Similarly, consumers make inferences about goods and services offered in the marketplace based on the extent of the attractiveness of the countries where they originated from. This is commonly tagged country-of-origin (COO) effect. As there are several stakeholders associated with places such as tourists, residents, and governments, it becomes imperative for place marketers to consider inclusivity in the formulation of brand strategies. This chapter explores these issues and how they are being influenced by the digital transformation which permeates virtually all elements of the marketing systems. Apart from unpacking these salient issues with references to some pertinent cases, the chapter also features a discussion of the future of place branding consumer behaviour as well as the wide-ranging implications of the ideas
Accelerating Delivery of Psychological Therapies after Stroke: A Feasibility Stepped Wedge Cluster Randomised Controlled Trial
Get PDFBackground: Psychological problems post-stroke are common and debilitating, yet insufficient evidence-based psychological support exists for stroke survivors, either in stroke or general mental health services. Many stroke survivors with significant needs remain unsupported. To address this problem, we need pathways to identify, treat and manage psychological difficulties after stroke. The Accelerating Delivery of Psychological Therapies after Stroke (ADOPTS) study aimed to explore the feasibility of collaboratively developing, implementing and evaluating intervention packages (IPs) to facilitate access to, and increase the provision of, psychological support post-stroke. Methods: Stakeholder groups were formed across four sites in north-west England, comprising stroke and psychological services, to collaboratively develop site-specific IPs incorporating a psychological care pathway, staff training, a staff manual for stroke-specific psychological support and supervision. A feasibility stepped-wedge cluster randomised trial recruited patients admitted with stroke during the usual care (pre-implementation of the IP) and intervention (post-implementation) periods. The feasibility of IP implementation and their potential usefulness were evaluated through assessing wellbeing and the support received, and through a process evaluation incorporating interviews with staff, patients and carers. Feasibility evaluation included the recruitment rate and attrition rate; exploratory analysis (mixed-effects linear or logistic regression models) was used to assess the ‘promise’ of the intervention in achieving psychological distress outcomes (mood (PHQ-9), anxiety (GAD-7)), assessed using validated measures at 6 weeks and 6 months. Results: IPs were collaboratively developed at each site but implementation took longer than the per-study-protocol duration of three months. Nineteen training sessions (152 attendees) were delivered for nursing, therapy, NHS Talking Therapies and voluntary staff. Nursing staff were underrepresented due to difficulties with releasing staff. Manuals were developed for each site, incorporating a mood screening and referral algorithm, but these were not finalised at one site. Stroke and NHS Talking Therapies champions were identified in each site to facilitate cross-service staff supervision. A total of 270 patients were recruited over 14 months (133 usual care, 137 intervention), with 227 and 198 at 6 weeks and 6 months, respectively. Stroke staff found the training, manual and pathway helpful, and reported greater confidence in managing and referring psychological issues. NHS Talking Therapies staff found the training useful for adapting their therapy. However, the intervention took longer to implement in all sites, requiring an additional time period to be added to the stepped-wedge design. Conclusions: It is feasible to collaboratively develop and implement IPs for post-stroke psychological support. However, an alternative to the stepped-wedge design used here would be more appropriate for a future study. This study was registered in ISRCTN—the UK’s Clinical Study Registry (trial registration: ISRCTN12868810, registration date: 4 February 2016)
Livedoid Vasculopathy
Get PDFLivedoid Vasculopathy (LV) is an uncommon thrombotic occlusive vasculopathy presenting with chronic relapsing-remitting painful skin ulcerations, predominantly affecting the feet and ankles bilaterally. LV can be idiopathic or secondary to varied causes including endothelial, rheological, haemostatic or fibrinolytic pathologies. We describe three LV cases here in with a review of the current literature on its epidemiology, risk factors and management options. It is of quite clinical significance to differentiate the LV from vasculitic disorders, as the management of the latter being based on immunosuppression, whereas LV treatment is mostly based around anticoagulant or antiplatelet therapy