• Experimental long-term diabetes mellitus alters the transcriptome and biomechanical properties of the rat urinary bladder

      Hindi, Emad A.; Williams, Craig J.; Zeef, Leo A. H.; Lopes, Filipa M.; Newman, Katie; Davey, Martha M. M.; Hodson, Nigel W.; Hilton, Emma N.; Huang, Jennifer L.; Price, Karen L.; et al. (Nature Publishing Group UK, 2021-07-30)
      Abstract: Diabetes mellitus (DM) is the leading cause of chronic kidney disease and diabetic nephropathy is widely studied. In contrast, the pathobiology of diabetic urinary bladder disease is less understood despite dysfunctional voiding being common in DM. We hypothesised that diabetic cystopathy has a characteristic molecular signature. We therefore studied bladders of hyperglycaemic and polyuric rats with streptozotocin (STZ)-induced DM. Sixteen weeks after induction of DM, as assessed by RNA arrays, wide-ranging changes of gene expression occurred in DM bladders over and above those induced in bladders of non-hyperglycaemic rats with sucrose-induced polyuria. The altered transcripts included those coding for extracellular matrix regulators and neural molecules. Changes in key genes deregulated in DM rat bladders were also detected in db/db mouse bladders. In DM rat bladders there was reduced birefringent collagen between detrusor muscle bundles, and atomic force microscopy showed a significant reduction in tissue stiffness; neither change was found in bladders of sucrose-treated rats. Thus, altered extracellular matrix with reduced tissue rigidity may contribute to voiding dysfunction in people with long-term DM. These results serve as an informative stepping stone towards understanding the complex pathobiology of diabetic cystopathy.
    • Experimental philosophical bioethics and normative inference.

      Earp, Brian D; orcid: 0000-0001-9691-2888; Lewis, Jonathan; orcid: 0000-0001-8342-1051; email: jonathan.lewis-2@manchester.ac.uk; Dranseika, Vilius; orcid: 0000-0002-1144-1624; Hannikainen, Ivar R; orcid: 0000-0003-0623-357X (2021-11-17)
      This paper explores an emerging sub-field of both empirical bioethics and experimental philosophy, which has been called "experimental philosophical bioethics" (bioxphi). As an empirical discipline, bioxphi adopts the methods of experimental moral psychology and cognitive science; it does so to make sense of the eliciting factors and underlying cognitive processes that shape people's moral judgments, particularly about real-world matters of bioethical concern. Yet, as a normative discipline situated within the broader field of bioethics, it also aims to contribute to substantive ethical questions about what should be done in a given context. What are some of the ways in which this aim has been pursued? In this paper, we employ a case study approach to examine and critically evaluate four strategies from the recent literature by which scholars in bioxphi have leveraged empirical data in the service of normative arguments. [Abstract copyright: © 2021. The Author(s).]
    • Exploratory study of the association in the United Kingdom between hypertension and inorganic arsenic (iAs) intake from rice and rice products

      Xu, Lingqian; Polya, David A.; email: david.polya@manchester.ac.uk (Springer Netherlands, 2020-04-28)
      Abstract: Hypertension risks arising from chronic exposure to inorganic arsenic (iAs) are well documented. Consumption of rice is a major iAs exposure route for over 3 billion people; however, there is a lack of epidemiological evidence demonstrating an association of hypertension risks with iAs intake from rice, especially in areas where there is little exposure from drinking water but a growing demand for rice intake. To address this, we conducted an individual-level cross-sectional analysis to quantify the extent to which daily iAs intake from rice and rice products (E-iAsing,rice) modifies the association between hypertension risks and previously well-established risk factors. The analysis was based on secondary dietary, socio-demographic and health status data of 598 participants recorded in the UK National Diet and Nutrition Survey 2014–2016. E-iAsing,rice and five blood pressure endpoints were derived with potential associations explored through generalized linear models. According to the results, a negative but not significant relationship was found between hypertension risks and E-iAsing,rice after adjusting for major risk factors, notably age, gender, diabetes and obesity, with relatively higher risks being observed for male, middle-aged, overweight, alcohol consumer or Asian or Asian British, Black or Black British and mixed ethnic groups. Though inconclusive and mainly limited by potential incomplete adjustment for major confounders and intrinsic disadvantages of a cross-sectional design, this study was the first quantifying the individual level dose–response relationship between E-iAsing,rice and hypertension risks and is consistent with previous studies on the limited associations of hypertension with low-level arsenic exposure from drinking water. Larger scale cohort studies are indicated to quantify the association but in any event it is likely to be weak.
    • Exploring AdaBoost and Random Forests machine learning approaches for infrared pathology on unbalanced data sets.

      Tang, Jiayi; orcid: 0000-0002-4135-0942; Henderson, Alex; orcid: 0000-0002-5791-8555; Gardner, Peter; orcid: 0000-0003-4034-3764 (2021-09-27)
      The use of infrared spectroscopy to augment decision-making in histopathology is a promising direction for the diagnosis of many disease types. Hyperspectral images of healthy and diseased tissue, generated by infrared spectroscopy, are used to build chemometric models that can provide objective metrics of disease state. It is important to build robust and stable models to provide confidence to the end user. The data used to develop such models can have a variety of characteristics which can pose problems to many model-building approaches. Here we have compared the performance of two machine learning algorithms - AdaBoost and Random Forests - on a variety of non-uniform data sets. Using samples of breast cancer tissue, we devised a range of training data capable of describing the problem space. Models were constructed from these training sets and their characteristics compared. In terms of separating infrared spectra of cancerous epithelium tissue from normal-associated tissue on the tissue microarray, both AdaBoost and Random Forests algorithms were shown to give excellent classification performance (over 95% accuracy) in this study. AdaBoost models were more robust when datasets with large imbalance were provided. The outcomes of this work are a measure of classification accuracy as a function of training data available, and a clear recommendation for choice of machine learning approach.
    • Exploring engagement with digital screens for collecting patient feedback in clinical waiting rooms: The role of touch and place

      Ong, Bie Nio; Sanders, Caroline; orcid: 0000-0002-0539-928X; email: caroline.sanders@manchester.ac.uk (SAGE Publications, 2019-12-09)
      Health service settings are increasingly installing digital devices to enable people to engage digitally with multiple processes, including automated ‘check-in’, as well as collecting feedback on experiences of care. In addition, policy is increasingly driving digital agendas to promote patient engagement with online services, management of health records and routine monitoring. While this tendency towards widespread digital diffusion has been viewed as a means of enabling greater empowerment of patients and improved responsiveness of services to ‘patient voice’, social scientists have provided critical insights on the use of digital technologies in practice. However, there remains limited understanding of the mechanisms and contexts for digital engagement. In particular, there is a need for further research on the sensory and spatial aspects of engagement that are integral to everyday use (or non-use) of technology in practice. This article reports new insights from detailed qualitative case studies utilising in-depth interviews with patients, carers and staff, in addition to ethnographic observations of different digital modalities and their usage in specific health care contexts. A sociomaterial approach and concepts of affective atmosphere and technogeography are drawn upon to analyse the role of touch and place in the collection of digital feedback in multiple waiting room settings for people with physical and mental health long-term conditions. The findings highlight how barriers to engagement varied by context such as particular concerns about privacy for those with mental health problems and physical and sensory barriers for those with physical impairments. The findings demonstrate how digital inequalities can play out in practice and have implications for the design and development of digital innovations and tackling inequalities that may be associated with implementation of new digital technologies in healthcare.
    • Exploring Gay Men’s Threesomes

      Scoats, Ryan; email: ryanscoatsphd@gmail.com; Anderson, Eric; email: eric.anderson@winchester.ac.uk; White, Adam J.; email: adamwhitephd@gmail.com (Berghahn Books, 2021-09-01)
      Although there is abundant research regarding group sex between men, much of the current literature constructs group sex as homogenous and overlooks the nuance of how and why men engage in particular sexual behaviors. Accordingly, this research expands our understanding of group sex by focusing on a specific type of sex: the threesome. The results demonstrate how perspectives on threesomes may develop over time; at first appearing exciting before becoming relatively normalized and indistinct from dyadic sex. Encounters and exposure are fostered through the sexual opportunities available, in particular, geo-social networking apps. Despite their normalization, threesomes are not necessarily viewed as risk free. Thus, this research offers insight and understanding into how gay men engage in group sex and the contextual factors which make it possible.
    • Exploring parameters of gamma transcranial alternating current stimulation (tACS) and full‐spectrum transcranial random noise stimulation (tRNS) on human pharyngeal cortical excitability

      Zhang, Mengqing; orcid: 0000-0002-1954-7802; Cheng, Ivy; orcid: 0000-0001-5853-7976; Sasegbon, Ayodele; orcid: 0000-0003-2050-0726; Dou, Zulin; Hamdy, Shaheen; orcid: 0000-0001-9640-7427; email: shaheen.hamdy@manchester.ac.uk (2021-06-03)
      Abstract: Background: Transcranial alternating current stimulation (tACS) and transcranial random noise stimulation (tRNS) have been shown to have physiological and functional effects on brain excitability and motor behavior. Yet, little is known about their effects in the swallowing system. Aim: To examine the effects and optimal stimulation parameters of tACS and tRNS for modulating excitability of human pharyngeal motor cortex. Methods: 10 Hz (alpha), 20 Hz (beta), 70 Hz (gamma) tACS, 0.1–640 Hz (full‐spectrum) tRNS, and sham were applied over pharyngeal motor cortices at 1.5 mA current intensity for 10 min in 15 healthy participants. Pharyngeal motor–evoked and thenar motor–evoked potentials (PMEPs and TMEPs) were assessed before and up to 2 h after stimulation with single‐pulse transcranial magnetic stimulation. Averaged MEP amplitude and latency changes were analyzed using repeated measures ANOVA (rmANOVA). Key Results: Two‐way rmANOVA across all active interventions demonstrated a significant MEP interaction both in the stimulated pharyngeal cortex (F (4, 56) = 1.731, p = 0.038) and in the ipsilateral thenar cortex (F (4, 56) = 1.506, p = 0.048). Compared to sham, subsequent post hoc tests showed site‐specific and sustained (60–120 min) increases in PMEPs with gamma tACS and tRNS (p = 0.005, p = 0.027, respectively) and for TMEPs with beta tACS (p = 0.006). Conclusions and Inferences: Our findings suggest that the effects of tACS and tRNS are frequency‐dependent and cortical (representation) site‐specific with both gamma tACS and full‐spectrum tRNS enhancing human pharyngeal cortical excitability. These techniques hold promise as potential treatments for neurological dysphagia.
    • Exploring patients' pharmacy stories: an analysis of online feedback.

      Loo, Jared; Greaves, Georgina; Lewis, Penny J; orcid: 0000-0002-3976-5807; email: penny.lewis@manchester.ac.uk (2021-06-19)
      Background Studies have demonstrated the potential for patient feedback to inform quality care as well as a direct relationship between patient experience and clinical outcomes. Over recent years, there has been increasing use of online patient feedback platforms, however, there has been little study of the content of patient feedback relating to pharmacy and pharmacy services. Objective This study explores the content of online feedback provided by patients from across the UK in relation to their experiences of their interaction with pharmacy staff and pharmacy services. Main outcome measure Content of online patient feedback relating to pharmacy. Method Patient stories published on Care Opinion, a national online patient feedback platform, for a one-year period were searched for all content relating to patients' pharmacy experiences. A thematic and sentiment analysis was conducted on 237 patient stories. Results Patient stories related to supply, staff attitudes, services, accessibility, systems, and errors. Patient sentiment depended on pharmacy setting, but staff attitudes, services, and accessibility were generally positive across all settings. Waiting time was the most common complaint in both hospital and community pharmacies with stories relaying experiences of slow discharge, stock shortages and poor communication and collaboration between pharmacies and GP surgeries. Conclusions Online patient feedback highlighted factors important to patients when interacting with pharmacies and their staff. Medication supply was the primary topic of patient stories with waiting times and stock shortages being clear areas for improvement; however, accessibility, pharmacy services and advice were key strengths of the profession. Further research is needed to understand how online patient feedback can be used effectively to inform improvements in pharmacy services.
    • Exploring patients' pharmacy stories: an analysis of online feedback.

      Loo, Jared; Greaves, Georgina; Lewis, Penny J; orcid: 0000-0002-3976-5807; email: penny.lewis@manchester.ac.uk (2021-06-19)
      Background Studies have demonstrated the potential for patient feedback to inform quality care as well as a direct relationship between patient experience and clinical outcomes. Over recent years, there has been increasing use of online patient feedback platforms, however, there has been little study of the content of patient feedback relating to pharmacy and pharmacy services. Objective This study explores the content of online feedback provided by patients from across the UK in relation to their experiences of their interaction with pharmacy staff and pharmacy services. Main outcome measure Content of online patient feedback relating to pharmacy. Method Patient stories published on Care Opinion, a national online patient feedback platform, for a one-year period were searched for all content relating to patients' pharmacy experiences. A thematic and sentiment analysis was conducted on 237 patient stories. Results Patient stories related to supply, staff attitudes, services, accessibility, systems, and errors. Patient sentiment depended on pharmacy setting, but staff attitudes, services, and accessibility were generally positive across all settings. Waiting time was the most common complaint in both hospital and community pharmacies with stories relaying experiences of slow discharge, stock shortages and poor communication and collaboration between pharmacies and GP surgeries. Conclusions Online patient feedback highlighted factors important to patients when interacting with pharmacies and their staff. Medication supply was the primary topic of patient stories with waiting times and stock shortages being clear areas for improvement; however, accessibility, pharmacy services and advice were key strengths of the profession. Further research is needed to understand how online patient feedback can be used effectively to inform improvements in pharmacy services.
    • Exploring Staff Implementation of a Self-directed Parenting Intervention for Parents with Mental Health Difficulties

      Butler, J.; Gregg, L.; Calam, R.; Wittkowski, A.; orcid: 0000-0003-3806-0183; email: anja.wittkowski@manchester.ac.uk (Springer US, 2020-05-22)
      Abstract: Parents with mental health difficulties face significant barriers in accessing evidence-based parenting interventions. Self-directed approaches may be a destigmatising, accessible alternative. Evidence has suggested that Triple P Positive Parenting Programme’s self-directed format is as effective as more time- and cost-intensive delivery methods. The aim of the current study was to establish whether staff were able to use this intervention with parents with mental health difficulties and to explore staff experiences of implementation. Triple P self-help workbooks were provided to practitioners across three teams. Data were collected regarding workbook uptake and use. Interviews with staff exploring their experiences of implementation were analysed using thematic analysis. Overall, 41 participants were recruited, of which 12 (29.27%) also consented to interviews. Overall, six practitioners (14.63%) reported that they utilised the workbook. Uptake and utilisation were varied, but practitioners who used the workbook reported positive outcomes. Interviews revealed themes regarding practitioner concerns, views of the intervention and implementation issues. Self-directed Triple remains a promising intervention but its feasibility is dependent on addressing barriers to implementation and facilitating a family-focused approach to meet the needs of these parents and their children.
    • Exploring the Development Needs of Postgraduate Taught Dissertation Supervisors

      Regan, Julie-Anne; Taylor, Kirsty; Simcock, Thomas; University of Chester (2014-10)
      The Graduate School, in collaboration with the Learning and Teaching Institute (LTI), undertook this project to explore the development needs of PGT dissertation supervisors. This information was vital to the effective planning of development opportunities, in order to enhance dissertation supervision on PGT programmes and ultimately improve the overall postgraduate student experience.
    • Exploring the mental health and wellbeing of professional academy footballers in England

      Sothern, Nicola A.; O’Gorman, Jimmy; orcid: 0000-0002-2524-3223 (Informa UK Limited, 2021-07-26)
    • Exploring the mental health and wellbeing of professional academy footballers in England

      Sothern, Nicola A.; O’Gorman, Jimmy; orcid: 0000-0002-2524-3223 (Informa UK Limited, 2021-07-26)
    • Exploring the STEP-uP to practice: A survey of UK Lead Midwives for Education views of the STudent midwife Extended Practice Placement during the first wave of the COVID-19 pandemic.

      Cooke, Alison; email: alison.cooke@manchester.ac.uk; Hancock, Angela; email: angela.hancock@manchester.ac.uk; White, Helen; email: helen.white@manchester.ac.uk; Clark, Nicky; email: n.j.clark@hull.ac.uk; Gibb, Fiona; email: f.gibb@rgu.ac.uk; McNeill, Jenny; email: j.mcneill@qub.ac.uk; Thomas, Grace; email: thomassg4@cardiff.ac.uk; Lloyd, Carmel; email: carmel.lloyd@rcm.org.uk; Furber, Christine; email: christine.furber@manchester.ac.uk (2021-05-28)
      to assess the effect of implementation of the extended placement option available to midwifery students during the first wave of the COVID-19 pandemic. Online survey open from 2nd June 2020 to 15th July 2020. United Kingdom. Lead Midwives for Education (LMEs). A total of 38 of 55 LMEs responded (response rate 69%). The majority of Approved Education Institutions (AEIs) offered an extended placement to students, but with some variation in the choices offered, unrelated to geographical location or size of student cohort. AEIs appeared to provide the majority of decisional support for students. Many practice learning environments became unavailable, particularly community, gynaecology/medical wards and neonatal units. LMEs experienced both internal and external pressures to instigate rapid change. The impact of COVID-19 on midwifery education is significant and will need continual scrutiny to minimise future detriment. The pressures of providing midwifery education throughout the early phase of COVID-19 were substantial, but it is important that we learn from the immediate changes made, value and pursue the changes that have been beneficial, and learn from those that were not. Student learning experiences have undergone significant change during the pandemic. It is essential to assess what effect the extended placement has had on student readiness for practice, their confidence, resilience, mental health, and attrition and retention. Educators transitioned to remote working, and rapidly assimilated new skills for online education; exploration of the impact of this is recommended. [Abstract copyright: Copyright © 2021. Published by Elsevier Ltd.]
    • Exposure to ambient air pollution during childhood and subsequent risk of self-harm: A national cohort study.

      Mok, Pearl L H; email: pearl.mok@manchester.ac.uk; Antonsen, Sussie; Agerbo, Esben; Brandt, Jørgen; Geels, Camilla; Christensen, Jesper H; Frohn, Lise M; Pedersen, Carsten B; Webb, Roger T (2021-09-16)
      A growing body of evidence indicates that exposure to air pollution not only impacts on physical health but is also linked with a deterioration in mental health. We conducted the first study to investigate exposure to ambient particulate matter with an aerodynamic diameter of less than 2.5 μm (PM ) and nitrogen dioxide (NO ) during childhood and subsequent self-harm risk. The study cohort included persons born in Denmark between January 1, 1979 and December 31, 2006 (N = 1,424,670), with information on daily exposures to PM and NO at residence from birth to 10th birthday. Follow-up began from 10th birthday until first hospital-presenting self-harm episode, death, or December 31, 2016, whichever came first. Incidence rate ratios estimated by Poisson regression models revealed a dose relationship between increasing PM exposure and rising self-harm risk. Exposure to 17-19 μg/m of PM on average per day from birth to 10th birthday was associated with a 1.45 fold (95% CI 1.37-1.53) subsequently elevated self-harm risk compared with a mean daily exposure of <13 μg/m , whilst those exposed to 19 μg/m or above on average per day had a 1.59 times (1.45-1.75) elevated risk. Higher mean daily exposure to NO during childhood was also linked with increased self-harm risk, but the dose-response relationship observed was less evident than for PM . Covariate adjustment attenuated the associations, but risk remained independently elevated. Although causality cannot be assumed, these novel findings indicate a potential etiological involvement of ambient air pollution in the development of mental ill health. [Abstract copyright: Copyright © 2021. Published by Elsevier Inc.]
    • Extending screening intervals for women at low risk of breast cancer: do they find it acceptable?

      McWilliams, Lorna; email: lorna.mcwilliams@manchester.ac.uk; Woof, Victoria G.; Donnelly, Louise S.; Howell, Anthony; Evans, D. Gareth; French, David P. (BioMed Central, 2021-05-29)
      Abstract: Background: Trials of risk estimation in breast cancer screening programmes, in order to identify women at higher risk and offer extra screening/preventive measures, are ongoing. It may also be feasible to introduce less frequent screening for women at low-risk of breast cancer. This study aimed to establish views of women at low-risk of breast cancer regarding the acceptability of extending breast screening intervals for low-risk women beyond 3 y. Methods: Semi-structured interviews were used to explore views of low-risk women, where “low-risk” was defined as less than 2% estimated 10-year risk of breast cancer aged > 46 years. Low-risk women were identified via the BC-Predict study, where following routine screening, women were given their 10-year risk of breast cancer by letter, along with additional information explaining breast cancer risk factors. To gain diversity of views, purposive sampling by ethnicity and socioeconomic background was used to recruit women. Data were analysed using thematic analysis. Results: Twenty-three women participated in individual interviews. Three themes are reported: (1) A good opportunity to receive risk estimation, where women found it worthwhile to receive a low-risk result although some were surprised if expecting a higher risk result; (2) Multi-faceted acceptability of extended screening intervals, with reactions to less frequent screening dependent on whether women were confident in being low-risk status and current safety evidence, (3) Passive approval versus informed choice, highlighting that women found it difficult to consider choosing less frequent screening without professionals’ recommendations, as they generally viewed attending breast screening as positive. Conclusions: Risk assessment and receiving a low-risk of breast cancer is acceptable although, further research is required with more diverse samples of women. Any recommendation of less frequent screening in this risk group should be evidence-based in order to be acceptable. Communication needs to be carefully developed, with a focus on ensuring informed choice, prior to trialling any extended screening recommendations in future studies.
    • Extensive cone-dependent spectral opponency within a discrete zone of the lateral geniculate nucleus supporting mouse color vision.

      Mouland, Josh W; Pienaar, Abigail; Williams, Christopher; Watson, Alex J; Lucas, Robert J; Brown, Timothy M; email: timothy.brown@manchester.ac.uk (2021-06-02)
      Color vision, originating with opponent processing of spectrally distinct photoreceptor signals, plays important roles in animal behavior. Surprisingly, however, comparatively little is understood about color processing in the brain, including in widely used laboratory mammals such as mice. The retinal gradient in S- and M-cone opsin (co-)expression has traditionally been considered an impediment to mouse color vision. However, recent data indicate that mice exhibit robust chromatic discrimination within the central-upper visual field. Retinal color opponency has been reported to emerge from superimposing inhibitory surround receptive fields on the cone opsin expression gradient, and by introducing opponent rod signals in retinal regions with sparse M-cone opsin expression. The relative importance of these proposed mechanisms in determining the properties of neurons at higher visual processing stages remains unknown. We address these questions using multielectrode recordings from the lateral geniculate nucleus (LGN) in mice with altered M-cone spectral sensitivity (Opn1mw ) and multispectral stimuli that allow selective modulation of signaling by individual opsin classes. Remarkably, we find many (∼25%) LGN cells are color opponent, that such cells are localized to a distinct medial LGN zone and that their properties cannot simply be explained by the proposed retinal opponent mechanisms. Opponent responses in LGN can be driven solely by cones, independent of cone-opsin expression gradients and rod input, with many cells exhibiting spatially congruent antagonistic receptive fields. Our data therefore suggest previously unidentified mechanisms may support extensive and sophisticated color processing in the mouse LGN. [Abstract copyright: Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.]
    • Extrinsic and Existential Mortality Risk in Reproductive Decision-Making: Examining the Effects of COVID-19 Experience and Climate Change Beliefs

      Gordon, David S.; email: david.gordon@chester.ac.uk (Frontiers Media S.A., 2021-06-11)
      While the COVID-19 pandemic has presented an immediate risk to human life around the world, climate change poses an arguably greater—although less immediate—threat to our species’ survival. Within the framework of life-history theory (LHT), this pre-registered study investigated whether extrinsic risk (i.e., external factors that pose a risk to an individual’s life, e.g., COVID-19) and existential risk (i.e., risks with outcomes that threaten the existence of humans as a species, e.g., climate change) had similar or different relationships with reproductive decision-making. A UK representative sample of 325 participants between 18 and 35 years of age was asked to indicate their ideal number of children, ideal age to start having children, and whether their desire for a child had recently changed. Participants were asked about their experiences of COVID-19 and given a series of scales with which to assess their beliefs about climate change. In support of LHT, the study found evidence that knowing people who had been hospitalized with or died of COVID-19 was associated with a greater ideal number of children. Conversely, there was no clear evidence of a relationship between climate change beliefs and reproductive decision-making. The repercussions for understanding how we interpret and respond to different forms of mortality risk are discussed.
    • Extrinsic and Existential Mortality Risk in Reproductive Decision-Making: Examining the Effects of COVID-19 Experience and Climate Change Beliefs.

      Gordon, David S (2021-06-11)
      While the COVID-19 pandemic has presented an immediate risk to human life around the world, climate change poses an arguably greater-although less immediate-threat to our species' survival. Within the framework of life-history theory (LHT), this pre-registered study investigated whether extrinsic risk (i.e., external factors that pose a risk to an individual's life, e.g., COVID-19) and existential risk (i.e., risks with outcomes that threaten the existence of humans as a species, e.g., climate change) had similar or different relationships with reproductive decision-making. A UK representative sample of 325 participants between 18 and 35 years of age was asked to indicate their ideal number of children, ideal age to start having children, and whether their desire for a child had recently changed. Participants were asked about their experiences of COVID-19 and given a series of scales with which to assess their beliefs about climate change. In support of LHT, the study found evidence that knowing people who had been hospitalized with or died of COVID-19 was associated with a greater ideal number of children. Conversely, there was no clear evidence of a relationship between climate change beliefs and reproductive decision-making. The repercussions for understanding how we interpret and respond to different forms of mortality risk are discussed. [Abstract copyright: Copyright © 2021 Gordon.]
    • Eye movement desensitization and reprocessing therapy for psychosis ( EMDRp ): Protocol of a feasibility randomized controlled trial with early intervention service users

      Varese, Filippo; orcid: 0000-0001-7244-598X; email: filippo.varese@manchester.ac.uk; Sellwood, William; Aseem, Saadia; Awenat, Yvonne; Bird, Leanne; Bhutani, Gita; Carter, Lesley‐Anne; Davies, Linda; Davis, Claire; Horne, Georgia; et al. (Wiley Publishing Asia Pty Ltd, 2020-11-22)
      Abstract: Aim: Traumatic events are involved in the development and maintenance of psychotic symptoms. There are few trials exploring trauma‐focused treatments as interventions for psychotic symptoms, especially in individuals with early psychosis. This trial will evaluate the feasibility and acceptability of conducting a definitive trial of Eye Movement Desensitization and Reprocessing for psychosis (EMDRp) in people with early psychosis. Methods: Sixty participants with first episode psychosis and a history of a traumatic/adverse life event(s)will be recruited from early intervention services in the North West of England and randomized to receive16 sessions of EMDRp + Treatment as Usual (TAU) or TAU alone. Participants will be assessed at baseline, 6 and 12 months post‐randomization using several measures of psychotic symptoms, trauma symptoms, anxiety, depression, functioning, service‐user defined recovery, health economics indicators and quality of life. Two nested qualitative studies to assess participant feedback of therapy and views of professional stakeholders on the implementation of EMDRp into services will also be conducted. The feasibility of a future definitive efficacy and cost‐effectiveness evaluation of EMDRp will be tested against several outcomes, including ability to recruit and randomize participants, trial retention at 6‐ and 12‐month follow‐up assessments, treatment engagement and treatment fidelity. Conclusions: If it is feasible to deliver a multi‐site trial of this intervention, it will be possible to evaluate whether EMDRp represents a beneficial treatment to augment existing evidence‐based care of individuals with early psychosis supported by early intervention services.