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Prolonged grief and posttraumatic stress disorder following the loss of a significant other: an investigation of cognitive and behavioural differences
No full textBackground: Cognitive behavioural correlates to bereavement-related mental health problems such a Prolonged Grief Disorder (PGD) and Posttraumatic Stress Disorder (PTSD) are of theoretical and clinical importance.
Methods: Individuals bereaved at least six months (N = 647) completed measures of loss-related cognitions and behaviours (i.e. loss-related memory characteristics, negative appraisals, coping strategies, grief resilience, and perceived social disconnection) and measures of PGD and PTSD symptoms. Individuals were assigned to one of four groups depending on probable clinical diagnoses (No-PGD/PTSD, PTSD, PGD, PGD+PTSD).
Results: Results indicated that higher loss-related memory characteristics and lower grief resilience increased the likelihood of a clinical problem. The PGD and PGD+PTSD groups reported significantly higher loss-related memory characteristics and appraisals compared to the PTSD group. Social disconnection increased the likelihood of comorbid PGD+PTSD in comparison to any other group.
Conclusions: Results indicate cognitive differences between loss-related cognitions, memory characteristics and coping strategies between PGD and PTSD, and points to distinct cognitive correlates to psychopathology following loss
Preverbal infants expect agents exhibiting counterintuitive capacities to gain access to contested resources
No full textClaims to supernatural power have been used as a basis for authority in a wide range of societies, but little is known about developmental origins of the link between supernatural power and worldly authority. Here, we show that 12- to 16-month-old infants expect agents exhibiting counterintuitive capacities to win out in a two-way standoff over a contested resource. Infants watched two agents gain a reward using either physically intuitive or physically counterintuitive methods, the latter involving simple forms of levitation or teleportation. Infants looked longer, indicating surprise, when the physically intuitive agent subsequently outcompeted a physically counterintuitive agent in securing a reward. Control experiments indicated that infants’ expectations were not simply motived by the efficiency of agents in pursuing their goals, but specifically the deployment of counterintuitive capacities. This suggests that the link between supernatural power and worldly authority has early origins in development
The impact of a lack of mathematical education on brain development and future attainment
No full textFormal education has a long-term impact on an individual’s life. However, our knowledge of the effect of a specific lack of education, such as in mathematics, is currently poor but is highly relevant given the extant differences between countries in their educational curricula and the differences in opportunities to access education. Here we examined whether neurotransmitter concentrations in the adolescent brain could classify whether a student is lacking mathematical education. Decreased γ-aminobutyric acid (GABA) concentration within the middle frontal gyrus (MFG) successfully classified whether an adolescent studies math and was negatively associated with frontoparietal connectivity. In a second experiment, we uncovered that our findings were not due to preexisting differences before a mathematical education ceased. Furthermore, we showed that MFG GABA not only classifies whether an adolescent is studying math or not, but it also predicts the changes in mathematical reasoning ∼19 mo later. The present results extend previous work in animals that has emphasized the role of GABA neurotransmission in synaptic and network plasticity and highlight the effect of a specific lack of education on MFG GABA concentration and learning-dependent plasticity. Our findings reveal the reciprocal effect between brain development and education and demonstrate the negative consequences of a specific lack of education during adolescence on brain plasticity and cognitive functions
Vervet monkeys socialize more when time budget constraints are experimentally reduced
No full textIn species that live in stable groups, successful management of time budget (i.e., the proportion of time involved in different behaviours) and social relationships has been proposed to be a key variable affecting individual fitness. Such management is limited by time constraints, which are group size and season dependancy. However, the link between time budget constraints and grooming patterns as a means to service social relationships has never been studied experimentally. Here, we reduced the time constraints of three wild vervet monkey (Chlorocebus aethiops pygerythrus) groups by offering them high quality food for 60 min in the morning. We conducted 10 trials in summer and 10 trials in winter. We found that vervet monkeys indeed reduced the proportion of time spent foraging during the rest of those days compared to control days and increased the proportion of grooming time spread over more bouts. Individuals that did not get access to the food still participated as much in grooming as those that did eat. In accordance with our expectations, social network analysis revealed a larger grooming network on supplementation days: vervet monkeys used their extra time to socialize with more different group members. Furthermore, following our predictions, the effect of provisioning was usually stronger during the winter season (when food was scarce and days shorter) than during the summer, and the number of conflicts decreased during supplementation days. Finally, despite the fact that adults and juveniles of all three groups increased their proportion of time spent grooming during supplementation days, few group and age differences emerged in the way vervet monkeys manage their time budget. Interestingly, some of these differences seem to be independent of group size. In conclusion, vervet monkeys seize the opportunity to increase the proportion of time spent in social behaviours if time budget constraints are reduced
Immune monitoring for advanced cell therapy trials in transplantation: which assays and when?
No full textA number of immune regulatory cellular therapies, including regulatory T cells and mesenchymal stromal cells, have emerged as novel alternative therapies for the control of transplant alloresponses. Clinical studies have demonstrated their feasibility and safety, however developing our understanding of the impact of cellular therapeutics in vivo requires advanced immune monitoring strategies. To accurately monitor the immune response, a combination of complementary methods is required to measure the cellular and molecular phenotype as well as the function of cells involved. In this review we focus on the current immune monitoring strategies and discuss which methods may be utilized in the future
Establishment of a fluorescent reporter of RNA-polymerase II activity to identify dormant cells
No full textDormancy, a reversible quiescent cellular state characterized by greatly reduced metabolic activity, protects from genetic damage, prolongs survival and is crucial for tissue homeostasis and cellular response to injury or transplantation. Dormant cells have been characterized in many tissues, but their identification, isolation and characterization irrespective of tissue of origin remains elusive. Here, we develop a live cell ratiometric fluorescent Optical Stem Cell Activity Reporter (OSCAR) based on the observation that phosphorylation of RNA Polymerase II (RNApII), a hallmark of active mRNA transcription elongation, is largely absent in dormant stem cells from multiple lineages. Using the small intestinal crypt as a model, OSCAR reveals in real time the dynamics of dormancy induction and cellular differentiation in vitro, and allows the identification and isolation of several populations of transcriptionally diverse OSCARhigh and OSCARlow intestinal epithelial cell states in vivo. In particular, this reporter is able to identify a dormant OSCARhigh cell population in the small intestine. OSCAR therefore provides a tool for a better understanding of dormant stem cell biology
Azithromycin and cefixime combination versus azithromycin alone for the out-patient treatment of clinically suspected or confirmed uncomplicated typhoid fever in South Asia: a randomised controlled trial protocol
No full textBackground: Typhoid and paratyphoid fever (enteric fever) is a common cause of non-specific febrile infection in adults and children presenting to health care facilities in low resource settings such as the South Asia. A 7-day course of a single oral antimicrobial such as ciprofloxacin, cefixime, or azithromycin is commonly used for its treatment. Increasing antimicrobial resistance threatens the effectiveness of these treatment choices. We hypothesize that combined treatment with azithromycin (active mainly intracellularly) and cefixime (active mainly extracellularly) will be a better option for the treatment of clinically suspected and culture-confirmed typhoid fever in South Asia.
Methods: This is a phase IV, international multi-center, multi-country, comparative participant-and observer-blind, 1:1 randomised clinical trial. Patients with suspected uncomplicated typhoid fever will be randomized to one of the two interventions: Arm A: azithromycin 20mg/kg/day oral dose once daily (maximum 1gm/day) and cefixime 20mg/kg/day oral dose in two divided doses (maximum 400mg bd) for 7 days, Arm B: azithromycin 20mg/kg/day oral dose once daily (max 1gm/day) for 7 days AND cefixime-matched placebo for 7 days. We will recruit 1500 patients across sites in Bangladesh, India, Nepal, and Pakistan. We will assess whether treatment outcomes are better with the combination after one week of treatment and at one- and three-months follow-up.
Discussion: Combined treatment may limit the emergence of resistance if one of the components is active against resistant sub-populations not covered by the other antimicrobial activity. If the combined treatment is better than the single antimicrobial treatment, this will be an important result for patients across South Asia and other typhoid endemic areas.
Clinicaltrials.gov registration: NCT04349826 (16/04/2020
Randomised controlled trial of oxygen therapy and high-flow nasal therapy in African children with pneumonia
No full textPurpose
The life-saving role of oxygen therapy in African children with severe pneumonia is not yet established.
Methods
The open-label fractional-factorial COAST trial randomised eligible Ugandan and Kenyan children aged > 28 days with severe pneumonia and severe hypoxaemia stratum (SpO2 3 h receipt of oxygen were excluded. The primary endpoint was 48 h mortality; secondary endpoints included mortality or neurocognitive sequelae at 28 days.
Results
The trial was stopped early after enrolling 1852/4200 children, including 388 in the severe hypoxaemia stratum (median 7 months; median SpO2 75%) randomised to HFNT (n = 194) or LFO (n = 194) and 1454 in the hypoxaemia stratum (median 9 months; median SpO2 88%) randomised to HFNT (n = 363) vs LFO (n = 364) vs permissive hypoxaemia (n = 727). Per-protocol 15% of patients in the permissive hypoxaemia group received oxygen (when SpO2
Conclusions
Respiratory support with HFNT showing potential benefit should prompt further trials
Patient involvement in health technology appraisal: a CASMI working paper
No full textA working paper on the role of patients in UK technology appraisal, based
on policy document analysis and informal discussions with stakeholders