Initial perception of the mentoring role and related mentors' approach of autonomy support or control in formal youth mentoring relationships

Mentors' initial perceptions of the mentoring role in formal youth mentoring bonds; and the subsequent characteristics of autonomy support or autonomy control in mentoring interactions developed by mentors after 5 months of mentoring experience are discussed in this paper. The data is drawn from a longitudinal phenomenological study conducted in the Czech mentoring scheme between 2010 and 2017. In-depth semi-structured interviews were collected with 10 mentoring matches over 1 year of mentoring involvement. The results of Interpretive phenomenological analysis showed differences in mentors' initial perceptions of the role, and related autonomy-supportive or autonomy-controlling characteristics in mentors' approach. The benefits and risks of resulting autonomy support or control in mentoring interactions are discussed. The results argue for the theoretical conceptualisation of a child-centred perspective in youth mentoring that aims at mentees' support of autonomy, active agency and empowement, thus arguing for further in-depth exploration of natural mentoring principles in child-centred perspective, supporting approaches such as youth-initiated mentoring, and broadening the discussion on good evidence-based mentoring practice in the EU context.

The Reception of Lacanian Theory and Practice by American Psychoanalytic Training Programs

This paper explores the principal reasons for the exclusion of Lacanian ideas from psychoanalytic training institutes in the United States. The history of Lacan's role in the International Psychoanalytical Association, from which essentially he was expelled, occupies a central place in this story. Significant issues arose also from his practice style and technical innovations, whose rationale remains controversial today. Another major obstacle for the reception of his work is the theoretical framework of Lacanian analysis, so different from that of other schools. Inclusion of its unfamiliar vocabulary and concepts poses practical problems for training programs. At a more fundamental level, the strong antihumanist evolution of Lacan's thought runs contrary to the increasingly relational and intersubjective orientation of American psychoanalysis. The incompatibility between the disparate languages of a scientific theory aiming at objectivity and a phenomenology of personal intentionality and meaning greatly limits the possibilities for dialogue. The tension between these perspectives cannot be resolved, but a productive exchange between them is possible if they are accepted as valid and complementary ways of speaking about human behavior.

Competencies in Pastoral Counseling: The Lived Experiences of Filipino Diocesan Parish Priests

Pastoral counseling has been a significant part of the priestly ministry in the Philippines. Nonetheless, literature about Filipino priests' lived experiences and competencies in counseling is almost non-existent. Using Interpretative Phenomenological Analysis (IPA), the researcher explored the lived experiences and competencies of Filipino diocesan parish priests in their role as pastoral counselors. The study was framed in Phenomenology, the Philippines Psychology Act of 2009, and the 2009 competencies of the Association for Spiritual, Ethical, and Religious Values in Counseling (ASERVIC), a division within the American Counseling Association (ACA). Data were collected using a semi-structured interview, and the analysis yielded seven (7) themes under three (3) clusters. The findings revealed that the participants lack the prerequisites to be rightfully called pastoral counselors. As priests continue to attend to people in need of counseling, the researcher calls on church leaders, the Psychological Association of the Philippines (PAP), and the Professional Regulation Commission (PRC) to address the practice of pastoral counseling in the country.

Analysis of ceRNA Regulatory Mechanism of Rape Pollen Allergy Based on Whole-Transcriptome Sequencing of Peripheral Blood Mononuclear Cells

Background

Rape pollen allergy is a common allergic reaction disorder that affects the health and life of patients seriously. The research on ceRNA regulatory network in rape pollen allergy is poor.

Methods

High throughput whole-transcriptome sequencing was conducted on rape pollen allergic samples and non-allergic samples. Differentially expressed microRNAs (DEmiRNAs), circRNAs (DEcircRNAs), long non-coding RNA (DElncRNAs), mRNA (DEmRNAs) were identified and a ceRNA regulatory network was constructed by Cytoscape. Functional enrichment analyses were performed on DEmRNAs in the ceRNA network. Then, the least absolute shrinkage and selection operator (LASSO) regression model was used to identify characteristic genes for rape pollen allergy. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic ability of characteristic genes.

Results

A total of 25 DEmiRNAs, 258 DEcircRNAs, 304 DElncRNAs, and 383 DEmRNAs in the allergic group compared with the non-allergic group were uncovered, respectively. A ceRNA network containing 21 miRNAs, 57 circRNAs, 28 lncRNAs, and 33 mRNAs was generated with 139 nodes and 160 edges. The signal transduction-related processes, immune-related processes, the ion, inorganic substance, and hormone regulation processes were associated with mRNAs in the ceRNA network. The results of pathway enrichment illustrated that mRNAs in the ceRNA were significantly linked to IL-17 signaling pathway, inflammatory mediator regulation of trp channels, GMP-PKG signaling pathway, signaling by GPCR, and GPCR downstream signaling pathway. Then, five characteristic genes (KCNQ3, CCR5, FOSB, CFAP43, and PRKG1) were defined by the LASSO algorithm. The AUC values of these genes indicated that these genes had a powerful discrimination ability in discriminating allergic samples from non-allergic samples.

Conclusion

Taken together, we revealed the ceRNA regulatory network in rape pollen allergy and excavated five characteristic genes (KCNQ3, CCR5, FOSB, CFAP43, and PRKG1) with the diagnostic value that may be a potential target in diagnosis and treatment.

Perceptions of social support and relationships while living with a brain tumour: a qualitative study

OBJECTIVE

Having a brain tumour can disrupt social roles and networks. Despite growing evidence on the significance of social support in adjustment to chronic illness, research rarely focuses on the role of relationships when coping with a brain tumour. The current study sought to explore individuals' experiences of social support, and the dynamics within their social relationships, following a diagnosis of a brain tumour.

METHODS

Interpretative Phenomenological Analysis (IPA) was used as a methodological framework. Participants were 12 individuals (83% female) aged 29-54 years diagnosed with primary brain tumour (83% low grade), on average 3.5 years post-diagnosis. In-depth semi-structured interviews were conducted, transcribed verbatim, and analysed using IPA.

RESULTS

Five themes were identified: Coping together in the family; Being concerned about others; Giving and receiving support; Needing to share the experience; and Negotiating independence. The results highlighted that the illness affected a whole network of closest relationships, and that coping was not an individual task.

CONCLUSION

Coping with the condition was deeply socially embedded. There was a cost associated with seeking support and participants did not always ask for it, in order not to burden the caregivers. Talking to others with similar diagnoses provided a sense of validation and belonging.

They have taken out my spinal cord: an interpretative phenomenological analysis of self-boundary in psychotic experience within a sociocentric culture

INTRODUCTION

In the tradition of phenomenological psychiatry, schizophrenia is described as a disturbance of the minimal self, i.e. the most basic form of self-awareness. This disturbance of the minimal self at the individual level is assumed to precede the intersubjective disturbances such as boundary weakening. However, the role of intersubjective disturbances in the emergence and recovery of schizophrenic experience still remains an open question. This phenomenological study focuses on how encounters with others shape self-experience during from psychosis by analyzing this process from the perspective of cultural differences, which in current research is especially under-researched. While most phenomenological accounts are based on first person-accounts from Western, individualist cultures where the self is conceived and experienced as separate to others, the present study qualitatively investigates psychotic experiences of patients from Jaffna, Sri Lanka.

METHOD

Semi-structured interviews were conducted with three participants with a diagnosis of schizophrenia or first episode psychosis. The interviews were transcribed and analyzed using interpretative phenomenological analysis (IPA). Eight group experiential themes were identified across interviews.

RESULTS

The data suggest that intersubjective processes of boundary weakening such as invasiveness and hyperattunement may shape minimal self-experience and more specifically contribute to a mistrust of the own senses and to hyper-reflexivity. Interestingly, boundary weakening yields pervasive emotions and can be experienced as a threat to the whole social unit. On the one hand, the strengthening of self-other-boundary was achieved through opposition, closedness and withdrawal from others. On the other hand, this study suggests that the re-opening of self-other-boundaries in response to the crisis may help establish connectedness and may lead to recovery.

The dynamics of sexual risk amongst South African youth in age-disparate relationships

Introduction

South Africa has the highest burden of HIV in the world with over 8 million people living with HIV. Young women and girls account for a quarter of new HIV infections while making up only 10% of the population. A key driver of HIV incidence is transactional and survival sex between adolescent girls or young women and older men (the latter referred to as 'sugar-daddies' or 'blessers'). This paper expands on the existing literature on age-disparate and intergenerational relationships to provide social and behavioural interpretations of how young men, commonly omitted from studies on this topic, and women in concurrent relationships with both their peers and older partners perceive and navigate sexual risk.

Method

We conducted a qualitative study in a rural setting of uMgungundlovu District, KwaZulu-Natal Province, with purposively selected male and female participants aged 18-24 years old in age-disparate relationships. Semi-structured in-depth interviews (IDI) were conducted and analysed using interpretative phenomenological analysis (IPA) to explore existing information, motivations, and behavioural practices around relationships and sexual risk.

Results

The themes and related sub-themes found through IPA included the following: (1) navigating dating: narratives that show a strong preference for being in an age-disparate relationship; the challenges that young people face when choosing an older person as a side partner; and social media applications seen as creating opportunities to meet side partners; and (2) the distribution of love and trust in a multi-party sexual network: condom (mis)use differentiates between straights-those in a serious relationship-and sides; and the power of eye-test seroguessing, the praxis of testing people visually for HIV in nullifying existing knowledge about sexual and reproductive health risk.

Discussion

This research offers an understanding of how schemas of non-condom use are organised. We observed that while condom-less sex is often viewed as essential to building social capital in a serious relationship, it is not the only factor that determines sexual relationship power. Eye-test seroguessing not only develops consortium (trust, reciprocity, and solidarity), but it fulfils the psycho-social need to belong to a network of serious relationships. Moreover, it is critical to the enactment of masculinities because it consolidates femininity to keep men happy, i.e., by being passive in the sexual encounter, women constrain their self-efficacy to act contrary to the conventions of reputable women. Therefore, it is plausible that in the serosorting that occurs prior to unprotected sexual acts, the power of eye-test seroguessing limits the ability to engage in safe sexual practices.

Indole-3-propionic acid, a product of intestinal flora, inhibits the HDAC6/NOX2 signaling and relieves doxorubicin-induced cardiomyocyte damage

The heart failure-gut hypothesis indicates that damage to intestinal mucosa leads to increased microbial translocation, resulting in alterations in metabolites entering the blood circulation. This process promotes the development of heart failure. This study aimed to reveal the involvement of indole-3-propionic acid (IPA), a microbiota-derived tryptophan metabolite, in heart failure. Human cardiomyocytes AC16 was treated with doxorubicin to induce in vitro heart failure model, the influences of IPA on the cellular viability, apoptosis, inflammation and oxidative stress were evaluated. Molecular docking and western blotting were used to initially illustrate the potential relationship between IPA and HDAC6. Through HDAC6 overexpression, its mediating role in the regulatory mechanism of IPA in the above aspects was further investigated. IPA was found to reduce the apoptosis, inflammation and oxidative stress in doxorubicin-treated cells. The visualized structure displayed that IPA bound to HDAC6 and that IPA reduced HDAC6 level. Additionally, HDAC6 overexpression reversed the regulation of IPA in the above aspects, indicating the HDAC6/NOX2 signals mediated the mechanism of IPA. Together, the present study revealed that IPA reduced oxidative stress, inflammatory response and apoptosis in cardiomyocytes via inhibiting the HDAC6/NOX2 signaling. The findings suggest that gut microbiota metabolites have potential in the treatment of heart failure.

"It's not about wanting to be thin or look small, it's about the way it feels": an IPA analysis of social and sensory differences in autistic and non-autistic individuals with anorexia and their parents

BACKGROUND

Despite increasing evidence to support an overlap between autism and anorexia nervosa (AN), underlying mechanisms remain poorly understood. Social and sensory factors have emerged as promising targets in both autism and AN, however there remains scope to compare these differences across autistic and non-autistic experiences of AN. Drawing on dyadic multi-perspectives, this study explored experiences of social and sensory differences in autistic and non-autistic adults and their parents and/or carers.

METHODS

Using interpretative phenomenological analysis (IPA), dyadic interviews were conducted with 14 dyads, with seven autistic dyads and seven non-autistic dyads. Data analysis was subjected to a triangulation of interpretations: (1) the participants themselves; (2) a neurotypical researcher; (3) and an Autistic researcher with lived/living experience of AN.

RESULTS

IPA identified three themes in each group, with similarities and differences between autistic and non-autistic dyads. Similar themes were identified regarding the importance of social connectedness and socio-emotional difficulties, as well a common lack of trust in the social and sensory self and body. Autism-specific themes centred on feelings of social 'defectiveness', disparities between sensing and expressing certain cues, and lifelong, multi-sensory processing differences. Non-autistic themes reflected social comparisons and inadequacy, and sensitivities to the learning of ideals and behaviour through early experiences.

CONCLUSIONS

While similarities were observed across both groups, there appeared to be notable differences in the perceived role and influence of social and sensory differences. These findings may have important implications on the delivery and modification of eating disorder interventions. Specifically, they suggest that while treatment targets may look similar, subtle differences in underlying mechanisms and approaches may be required for Autistic individuals with AN across sensory, emotion and communication-based interventions.

Challenges for the Mental Health of Refugee Artists: Perspectives of the ADAPT Model

This study aimed to address the mental health challenges faced by refugee artists who are grantees of ICORN-the International Cities of Refuge Network-from the perspective of the extended conceptual ADAPT model. The study employed exploratory qualitative research, and data were collected through semi-structured interviews with ICORN artists in Poland, Norway, and Sweden. For data analysis, Interpretive Phenomenological Analysis (IPA) was used, whereas for the presentation of the results, the framework of the ADAPT model was applied. The results showed that the super-ordinate themes that emerged from the IPA analysis related directly to the ADAPT model and could mostly be assigned to its basic pillars: (1) Security; (2) Bonds and Networks; (3) Justice; (4) Roles and Identities; and (5) Existential Meaning. However, the model was insufficient for capturing the full diversity of experiences described by the respondents. Therefore, an extension of the model in the form of two additional pillars, Art and Body and Mind, was proposed. The findings confirm that the ADAPT model is adequate for systematizing and depicting in detail the experiences of migrants/refugees. However, further modifications of the model are necessary, particularly the additional pillar Body and Mind, which has the potential to become a separate category in other migrants'/refugees' assessment frameworks. Moreover, Art itself could be seen as a universal bridging factor between the refugee and the host population, contributing to the refugees' adaptation to the host society.

Nature-Based Mindfulness: A Qualitative Study of the Experience of Support for Self-Regulation

Self-regulation is pivotal for human well-being and mental health. In this qualitative study, we followed a randomized controlled trial (RCT) and explored how a five-day residential mindfulness program in a restorative natural setting supported self-regulation among university students experiencing moderate to severe stress. Six participants were interviewed post intervention and at three months' follow-up on how they experienced the retreat. Through interpretative phenomenological analysis, four interrelated themes emerged: "supportive conditions", "attitudes of mindfulness", "connection" and "physical and psychological balance." These themes reflected the outcomes of the retreat that participants valued in stressful situations. A progression occurred during the retreat through the themes, with emphasis developing from the supportive conditions of the setting, to cultivating mindful attitudes, over connection to both self, others and nature, to changes and effects on the physical, psychological and even spiritual level. In addition, participants emphasized experiences of positive emotions, energy, calmness, meta-awareness and the feeling of being part of the web of life. In conclusion, participants' experiences with a five-day nature-based mindfulness intervention revealed a range of qualities of both physical-, psychological-, social- and spiritual nature that are supportive for self-regulation.

Evaluating the quality of the public transport service during the COVID-19 pandemic from the perception of two user groups

The current paper focuses on a comparative analysis of both public transport (PT) and private vehicle (PV) users' perceptions on the quality of the service. To detect the key components of PT attributes a new hybrid methodology is applied, combining the importance-performance analysis and the importance-performance map analysis. The proposed hybrid approach is simpler and more integrated than the existing methods in the literature. The sample comprises an online panel and a total of 1028 questionnaires for PV and PT users surveyed during the pandemic period in Budapest. The results of the applied methods show that among the different groups, the service hour, the proximity, and the frequency attributes are important and performed well in the years of COVID-19. On the other hand, the temperature and the cleanliness factors are not significant predictors of the PV and PT users' general satisfaction. The obtained results can be used by local governments and authorities, who seek to identify areas to enhance the service quality of PT during movement restrictions in a pandemic wave.

Exploring the impact on primary care mental health practitioners of the death of a patient by suicide: An IPA study

OBJECTIVES

There have been numerous qualitative studies into the impact of the death of a patient by suicide on clinicians, but the majority of studies have focussed on psychiatrists and psychologists, primarily in inpatient or secondary care settings. To date, little has been done to explore the impact of such deaths on other mental health practitioners working in primary care, such as those working in Improving Access to Psychological Therapies (IAPT) services.

DESIGN

This qualitative study used purposive sampling and adopted an interpretative phenomenological analysis (IPA) methodology.

METHOD

All participants had experienced the death of a patient in their role as a practitioner in an IAPT service. Seven practitioners were recruited from services across the North of England. Semi-structured, one-hour telephone interviews were audio recorded and then transcribed verbatim.

RESULTS

Analysis of the transcripts identified a number of themes, which were represented in the majority of cases. Specifically, the analyses yielded four superordinate themes: (1) feeling shocked and upset about the death of a patient; (2) attempting to understand the causes of the suicide; (3) learning from the tragic event; and (4) reflections on what helped in coping with the tragic event. The emotional responses of shock, upset, guilt and fear of blame by IAPT practitioners following the death of a patient through suicide is consistent with that found in studies of other mental health practitioners.

CONCLUSIONS

It is hoped that the current study will help raise awareness amongst primary care mental health practitioners, services and training centres, of the impact of losing a patient to suicide and will encourage them to consider how best to prepare and support practitioners in this eventuality. Recommendations include raising awareness of the potential for patient suicide in primary care services, providing clarity on the individualised support available and on the requirements of investigations.

Optimizing palliative care education through undergraduate nursing students' perceptions: Application of importance-performance analysis and Borich needs assessment model

BACKGROUND

With the aging of the population and the increasing trend of chronic illnesses, the demand for palliative care is growing. Undergraduate nursing students will be the main providers of palliative care in the future. Therefore, it's important to enhance their capability for palliative care.

OBJECTIVES

The purpose of this study was to optimize palliative care education, based on undergraduate nursing students' perceptions and educational needs through the application of the importance-performance analysis and Borich needs assessment model.

DESIGN

A cross-sectional descriptive study.

SETTING

Nursing department in Wenzhou, China.

PARTICIPANTS

A total of 448 full-time undergraduate nursing students were recruited for the study.

METHODS

Importance-performance analysis was used to identify items that obtain high priority for improvement, and the Borich needs assessment model and the Locus for focus model were used to prioritize educational needs. The three methods were integrated to determine the top-priority content to meet undergraduate nursing students' educational needs in palliative care.

RESULTS

The items located in Quadrant II of Importance-performance analysis, ranked in the first 10 in Borich needs assessment, and located in Quadrant I of the Locus for focus model were defined as top-priority content. These included: "respiratory symptoms: pleural effusion, superior vena cava syndrome, respiratory difficulty," "Care of terminal symptoms," "Awareness of dying," "Care of remains," "Cooperation between interdisciplinary teams," and "Rights and interests of dying patients."

CONCLUSION

Several years of development of palliative care education have made nursing students aware of its importance. However, they have reported that education remains insufficient. A greater focus on palliative care education is needed to ensure they are better prepared. Specific attention should be given to cooperation between interdisciplinary teams, dealing with death and dying, rights and interests of people who were dying.

Personal meaning of recovery among persons with schizophrenia

BACKGROUND

Recovery in mental illness is not synonymous with cure. Personal recovery approach consider recovery as a process and not as an outcome. This approach takes into account the subjective meaning of recovery by assessing how a person has learned to accommodate and live with an illness.

AIM

To study the personal meaning of recovery among persons with schizophrenia.

METHOD

This article presents the findings of a qualitative study about what 'recovery' means to persons with schizophrenia. A semi structured interview schedule was prepared based on literature review and expert opinion. Twenty participants who met the inclusion criteria and personally consider themselves recovering/recovered from schizophrenia were selected for the in-depth qualitative interviews. Data was analyzed using Interpretative Phenomenological Analysis (IPA). Meaning of recovery from each participant's perspective was recorded.

FINDINGS

The results indicate factors that patients deem important for their recovery are, absence of symptoms, regaining functioning, being able to work, having adequate emotional stability and not being on medicines. The findings are examined in the background of the previous studies and suggestions for clinical practice and research is also discussed.

CONCLUSION

Recovery is far more than remission of symptoms. Persons with mental illness has their own criteria of recovery, which could be very distinct from the clinical definition. Current study findings can help in identifying meaning of recovery through the perspectives of persons with mental illness and in developing and implementing recovery-oriented services.

Invasive Pulmonary Aspergillosis: Not Only a Disease Affecting Immunosuppressed Patients

Fungal infections have become a common threat in Intensive Care Units (ICU). The epidemiology of invasive fungal diseases (IFD) has been extensively studied in patients severely immunosuppressed over the last 20-30 years, however, the type of patients that have been admitted to hospitals in the last decade has made the healthcare system and ICU a different setting with more vulnerable hosts. Patients admitted to an ICU tend to have older age and higher severity of disease. Moreover, the number of patients being treated in ICU are often immunosuppressed as a result of the widespread use of immunomodulatory agents, such as corticosteroids, chemotherapy, and biological agents. The development of Invasive Pulmonary aspergillosis (IPA) reflects a different clinical trajectory to affected patients. The increasing use of corticosteroids would probably explain the higher incidence of IPA especially in critically ill patients. In refractory septic shock, severe community-acquired pneumonia (SCAP), and acute respiratory distress syndrome (ARDS), the use of corticosteroids has re-emerged in order to decrease unacceptably high mortality rates associated with these clinical conditions. It is also pertinent to note that different reports have used different diagnosis criteria, and this might explain the different incidence rates. Another layer of complexity to better understand current IPA data is related to more aggressive acquisition of samples through invasive respiratory examinations.

Combined analysis of gut microbiome and serum metabolomics reveals novel biomarkers in patients with early-stage non-small cell lung cancer

Non-small cell lung cancer (NSCLC) is the predominant form of lung cancer and is one of the most fatal cancers worldwide. Recently, the International Association for the Study of Lung Cancer (IASLC) proposed a novel grading system based on the predominant and high-grade histological patterns for invasive pulmonary adenocarcinoma (IPA). To improve outcomes for NSCLC patients, we combined serum metabolomics and fecal microbiology to screen biomarkers in patients with early-stage NSCLC and identified characteristic microbial profiles in patients with different grades of IPA. 26 genera and 123 metabolites were significantly altered in the early-stage NSCLC patients. Agathobacter, Blautia, Clostridium, and Muribaculacea were more abundant in the early-stage NSCLC patients compared with healthy controls. For the different grades of IPA, the characteristic microorganisms are as follows: Blautia and Marinobacter in IPA grade type 1; Dorea in IPA grade type 2; and Agathobacter in IPA grade type 3. In the metabolome results, the early-stage NSCLC group mainly included higher levels of sphingolipids (D-erythro-sphingosine 1-phosphate, palmitoyl sphingomyelin), fatty acyl (Avocadyne 1-acetate, 12(S)-HETE, 20-Carboxy-Leukotriene B4, Thromboxane B3, 6-Keto-prostaglandin f1alpha, Sebacic acid, Tetradecanedioic acid) and glycerophospholipids (LPC 20:2, LPC 18:0, LPC 18:4, LPE 20:2, LPC 20:1, LPC 16:1, LPC 20:0, LPA 18:2, LPC 17:1, LPC 17:2, LPC 19:0). Dysregulation of pathways, such as sphingolipid metabolism and sphingolipid signaling pathway may become an emerging therapeutic strategy for early-NSCLC. Correlation analysis showed that gut microbiota and serum metabolic profiles were closely related, while Muribaculacea and Clostridium were the core genera. These findings provide new biomarkers for the diagnosis of early-stage NSCLC and the precise grading assessment of prognostic-related IPAs, which are of clinical importance and warrant further investigation of the underlying molecular mechanisms.

A Safe Place to Learn: Peer Research Qualitative Investigation of gameChange Virtual Reality Therapy

BACKGROUND

Automated virtual reality (VR) therapy has the potential to substantially increase access to evidence-based psychological treatments. The results of a multicenter randomized controlled trial showed that gameChange VR cognitive therapy reduces the agoraphobic avoidance of people diagnosed with psychosis, especially for those with severe avoidance.

OBJECTIVE

We set out to use a peer research approach to explore participants' experiences with gameChange VR therapy. This in-depth experiential exploration of user experience may inform the implementation in clinical services and future VR therapy development.

METHODS

Peer-led semistructured remote interviews were conducted with 20 people with a diagnosis of psychosis who had received gameChange as part of the clinical trial (ISRCTN17308399). Data were analyzed using interpretative phenomenological analysis and template analyses. A multiperspectival approach was taken to explore subgroups. Credibility checks were conducted with the study Lived Experience Advisory Panel.

RESULTS

Participants reported the substantial impact of anxious avoidance on their lives before the VR intervention, leaving some of them housebound and isolated. Those who were struggling the most with agoraphobic avoidance expressed the most appreciation for, and gains from, the gameChange therapy. The VR scenarios provided "a place to practise." Immersion within the VR scenarios triggered anxiety, yet participants were able to observe this and respond in different ways than usual. The "security of knowing the VR scenarios are not real" created a safe place to learn about fears. The "balance of safety and anxiety" could be calibrated to the individual. The new learning made in VR was "taken into the real world" through practice and distilling key messages with support from the delivery staff member.

CONCLUSIONS

Automated VR can provide a therapeutic simulation that allows people diagnosed with psychosis to learn and embed new ways of responding to the situations that challenge them. An important process in anxiety reduction is enabling the presentation of stimuli that induce the original anxious fears yet allow for learning of safety. In gameChange, the interaction of anxiety and safety could be calibrated to provide a safe place to learn about fears and build confidence. This navigation of therapeutic learning can be successfully managed by patients themselves in an automated therapy, with staff support, that provides users with personalized control. The clinical improvements for people with severe anxious avoidance, the positive experience of VR, and the maintenance of a sense of control are likely to facilitate implementation.

Therapeutic work with clients living in poverty

BACKGROUND

Financial inequalities appear to be increasing and poverty is becoming ubiquitous. Poverty affects mental health but its impact on mental health and wellbeing is rarely highlighted within health research.

AIMS

The Covid-19 pandemic, the Ukrainian invasion and other international and national events have led to a cost-of-living crisis for many people. This is likely to lead to an increase in related referrals and therefore active consideration of the relevant issues relating to poverty appears vital. This paper reports a study which sought to understand how therapists experienced their work with clients who self-refer due to living in poverty.

METHOD

Eight therapists participated in semi-structured interviews analysed using Interpretative Phenomenological Analysis (IPA).

RESULTS

Three superordinate themes were elicited: firstly 'Resilience in the struggle to engage with therapeutic work', secondly 'Struggling to promote social activism' and thirdly, 'Navigating multiple challenges and barriers'. Each superordinate theme contains two or three sub themes.

CONCLUSIONS

Issues of structural inequality (including but not limited to poverty) impact significantly on people's lives but are often ignored or minimised in therapeutic work. It is important that therapists are aware of poverty and take this into account when working with clients.

Analysis of risk factors of fungal superinfections in viral pneumonia patients: A systematic review and meta-analysis

BACKGROUND

Infections with fungi, such as Aspergillus species, have been found as common complications of viral pneumonia. This study aims to determine the risk factors of fungal superinfections in viral pneumonia patients using meta-analysis.

OBJECTIVE

This study aims to determine the risk factors of fungal infection s in viral pneumonia patients using meta-analysis.

METHODS

We reviewed primary literature about fungal infection in viral pneumonia patients published between January 1, 2010 and September 30, 2020, in the Chinese Biomedical Literature, Chinese National Knowledge Infrastructure, Wanfang (China), Cochrane Central Library, Embase, PubMed, and Web of Science databases. These studies were subjected to an array of statistical analyses, including risk of bias and sensitivity analyses.

RESULTS

In this study, we found a statistically significant difference in the incidence of fungal infections in viral pneumonia patients that received corticosteroid treatment as compared to those without corticosteroid treatment (p < .00001). Additionally, regarding the severity of fungal infections, we observed significant higher incidence of invasive pulmonary aspergillosis (IPA) in patients with high Acute Physiology and Chronic Health Evaluation (APACHE) II scores (p < .001), tumors (p = .005), or immunocompromised patients (p < .0001).

CONCLUSIONS

Our research shows that corticosteroid treatment was an important risk factor for the development of fungal infection in patients with viral pneumonia. High APACHE II scores, tumors, and immunocompromised condition are also important risk factors of developing IPA. The diagnosis of fungal infection in viral pneumonia patients can be facilitated by early serum galactomannan (GM) testing, bronchoalveolar lavage fluid Aspergillus antigen testing, culture, and biopsy.

Family Recovery from Addiction and Trauma: An Interpretative Phenomenological Analysis of Mothers' Lived Experience

INTRODUCTION AND AIMS

Addiction has a devastating impact in the lives of millions of people worldwide. Mothers constitute a hidden population. Previous research did not focus on mothers' experience of recovery.

METHODS

An Interpretative Phenomenological Analysis was used to analyze the experiences of 10 mothers whose young adult son/or daughter was in recovery from addiction.

FINDINGS

Four themes delineated mothers' lived experience of the long journey from traumatic loss and isolation to traumatic growth and connection: (a) Trauma and despair. Loss of relationships and healthy family life, (b) coping strategies, (c) finding meaning and constructing a new identity, and (d) connection and gratitude. Overall, halting the descent into despair involved a perceptual shift that restored meaning, relationships, and hope and alleviated mothers' feelings of chronic grief and distress over their adult child's addiction problems.

CONCLUSIONS

Addiction can have a damaging traumatic impact on mothers which is enhanced by social and self-stigmatizing processes. Ambiguous loss can occur when one's child uses substances, as the child may be physically present yet be psychologically absent in terms of the mother (and the family). Understanding the experience of mothers may help health and social care professionals to develop compassion, patience, and empathy towards mothers of persons with addiction problems. Mental health professionals need to be aware of the devastating impact of addiction problems on all family members in order to validate their experiences and support them in recovering from trauma and loss in the family.

"It seems impossible that it's been made so quickly": a qualitative investigation of concerns about the speed of COVID-19 vaccine development and how these may be overcome

The speed of COVID-19 vaccine development has been identified as a central concern contributing to hesitancy in acceptance. We conducted qualitative interviews to gain a greater understanding into these concerns and to identify what might address them. Twelve qualitative interviews were conducted with participants identifying as hesitant for COVID-19 vaccination and reporting concern about the speed of vaccine development. Interpretative Phenomenological Analysis (IPA) was used. Concerns about speed comprised the linked themes of i) difficulty understanding the pace, and, ii) worry about the implications for vaccine safety. Uncertainties concerning the pandemic led to a notable desire for credible and understandable information regarding the vaccines, which many participants felt was not available. Four routes to resolving uncertainty about whether to be vaccinated were identified. First, waiting for more information about the vaccines, such as about their contents and impact on transmission. Second, a growing perception that the vaccines must be safe given the large numbers already vaccinated. Third, viewing the vaccines as necessary - even if unappealing - for ending the pandemic. Finally, a feeling that there would be no choice but to have a vaccine. Examples of what might reduce hesitancy were given, including interviews with vaccine developers and knowing others of similar age having safely been vaccinated. The pace of development broke expectations set earlier in the pandemic. This was interpreted negatively due to a perceived lack of credible information. Most participants could envisage ways their concerns could be resolved, enough for them to have a vaccine.

"It Almost Makes Her Human": How Female Animal Guardians Construct Experiences of Cat and Dog Empathy

Understanding how humans perceive and construct experiences of non-human animal empathy (hereafter, 'animal/s') can provide important information to aid our understanding of how companion animals contribute to social support. This study investigates the phenomenology of animal empathy by examining how humans construct sense-making narratives of these experiences, with the hypothesis that anthropomorphic attributions would play a key role in these constructions. Comprehensive, semi-structured interviews were conducted with six participants, using established interpretative phenomenological analysis methodology to facilitate deep examination of how they interpreted and reacted emotionally. Participants were consistent in reporting changes to their companion animals' normal behaviour as the key to the identification of animal empathy experiences, yet they were highly paradoxical in their constructions of perceived internal drivers within their dogs and cats. Explanations were highly dichotomous, from highly anthropomorphic to highly anthropocentric, and these extremes were combined both within individual participant narratives and within some thematic constructs. This research demonstrates that experiences of companion animal empathy can be powerful and meaningful for humans, but the inconsistent mixture of anthropomorphic and anthropocentric reasoning illustrates the confused nature of human understanding of animals' internal states. Insight into how humans construct animal empathy has implications for the moral status of these animals and an application for companion animals used explicitly for social support, such as in animal-assisted therapy and emotional support animals.

Integrating Pharmacogenomics Data-Driven Computational Drug Prediction with Single-Cell RNAseq to Demonstrate the Efficacy of a NAMPT Inhibitor against Aggressive, Taxane-Resistant, and Stem-like Cells in Lethal Prostate Cancer

Metastatic prostate cancer/PCa is the second leading cause of cancer deaths in US men. Most early-stage PCa are dependent on overexpression of the androgen receptor (AR) and, therefore, androgen deprivation therapies/ADT-sensitive. However, eventual resistance to standard medical castration (AR-inhibitors) and secondary chemotherapies (taxanes) is nearly universal. Further, the presence of cancer stem-like cells (EMT/epithelial-to-mesenchymal transdifferentiation) and neuroendocrine PCa (NEPC) subtypes significantly contribute to aggressive/lethal/advanced variants of PCa (AVPC). In this study, we introduced a pharmacogenomics data-driven optimization-regularization-based computational prediction algorithm ("secDrugs") to predict novel drugs against lethal PCa. Integrating secDrug with single-cell RNA-sequencing/scRNAseq as a 'Double-Hit' drug screening tool, we demonstrated that single-cells representing drug-resistant and stem-cell-like cells showed high expression of the NAMPT pathway genes, indicating potential efficacy of the secDrug FK866 which targets NAMPT. Next, using several cell-based assays, we showed substantial impact of FK866 on clinically advanced PCa as a single agent and in combination with taxanes or AR-inhibitors. Bulk-RNAseq and scRNAseq revealed that, in addition to NAMPT inhibition, FK866 regulates tumor metastasis, cell migration, invasion, DNA repair machinery, redox homeostasis, autophagy, as well as cancer stemness-related genes, HES1 and CD44. Further, we combined a microfluidic chip-based cell migration assay with a traditional cell migration/'scratch' assay and demonstrated that FK866 reduces cancer cell invasion and motility, indicating abrogation of metastasis. Finally, using PCa patient datasets, we showed that FK866 is potentially capable of reversing the expression of several genes associated with biochemical recurrence, including IFITM3 and LTB4R. Thus, using FK866 as a proof-of-concept candidate for drug repurposing, we introduced a novel, universally applicable preclinical drug development pipeline to circumvent subclonal aggressiveness, drug resistance, and stemness in lethal PCa.

Dataset for electronic and optical properties of Y2O2S and Er dopped Y2O2S calculated using density functional theory and simulated x-ray near edge spectra

The computational data presented in this paper refer to the research article "Optical properties and simulated x-ray near edge spectra for Y2O2S and Er doped Y2O2S". We present the data used to calculate the structural, electronic, and optical properties of the Y2O2S and its Er+3 doped counterparts at various concentrations using density functional theory (DFT) and simulated X-ray near edge (XANES) spectra. We report electronic information from DFT and DFT+U generated from the Vienna Ab initio Simulation Package (VASP) using PAW pseudopotentials. We also report VASP calculated optical properties for the host Y2O2S using the independent particle approximation (IPA), the random phase approximation (RPA), the many-body GW0 approximation, and the Bethe-Salpeter equation (BSE) approximation, under the 10-atom unit cell. The IPA calculations are repeated using the 80-atom unit cell for both the host Y2O2S and the Y2O2S:Er+3 counterparts. The optical properties data include the frequency-dependent real and imaginary parts of the dielectric function, the absorption and extinction coefficients, the refractive index, and the reflectivity. FEFF10 XANES calculations are performed on the Y K-, L1-, L2-, and L3-edges, as well as on the Er M5-edge.