Introduction The global burden of chronic immune-mediated inflammatory diseases (IMIDs) is increasing, and rising prevalence rates significantly affect socioeconomic factors and quality of life. Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), along with ankylosing spondylitis (AS), are prominent chronic IMIDs that share overlapping pathophysiological mechanisms. Recent research has highlighted the importance of the gut microbiota in the pathogenesis of these diseases, suggesting that shared microbial dysbiosis may contribute to their development. Comprehensive research focusing on the gut and oral microbial characteristics and environmental factors is essential to elucidate the fundamental pathophysiology and develop personalised management strategies for IBD and AS. In-depth analyses and insights based on multiomics approaches are required to achieve these objectives.Methods and analysis This protocol describes a nationwide prospective observational study of CD, UC and AS in a Korean population. Over 5 years, we aim to recruit at least 900 patients with IBD and 200 first-degree relatives (FDRs), 500 patients with AS and 200 of their FDRs, and 2244 healthy controls. We will systematically collect clinical data and biological samples, including saliva, stool, blood and tissue biopsies, for integrative multiomics analyses focusing primarily on the microbiome. Highly advanced full-length 16S ribosomal RNA gene sequencing and shotgun metagenomics will be used to characterise the microbial composition of saliva and stool samples. Quantitative microbiome profiling will be used to address the pathological, physiological and ecological differences between microbial groups that may be masked by their relative abundance. Metabolomic analyses will be conducted on saliva, stool and plasma samples to assess functional metabolic profiles. Culturomics will be used to isolate, identify and characterise the diversity of microbial species, including rare or previously unrecognised species, to provide a comprehensive understanding of the microbiota associated with these diseases.Ethics and dissemination Ethical approval was obtained from the Ethics Committee of Kyung Hee University Hospital, Hanyang University Hospital, Kangbuk Samsung Hospital, Yeungnam University Hospital, Kyungpook National University Hospital, Chonnam National University Hospital, Wonkwang University Hospital, Catholic University Daejeon St. Mary’s Hospital, Soon Chun Hyang University Hospital Cheonan, Chung-Ang University Hospital, Inje University Haeundae Paik Hospital, Dankook University Hospital, Hanyang University Guri Hospital, Kyung Hee University Hospital at Gangdong, Chung-Ang University Gwangmyeong Hospital and Keimyung University Dongsan Hospital. Our research team will provide detailed information about the study, including an information sheet explaining its aims and procedures, prior to enrolment. Prospective participants will be informed that they have the right to withdraw from the study at any time, without penalty. Participants will be assured of the anonymity and confidentiality of any data they provide throughout the study, using participant numbers and the storage of sensitive data in locked cabinets. Participants will be enrolled in the study only after providing written informed consent to the research staff. The results of this study will be disseminated to healthcare and academic professionals through publications in peer-reviewed journals and presentations at international conferences.Trial registration number This prospective observational study is registered at ClinicalTrials.gov ((ID: NCT06124833, data first posted: 9 November 2023); (ID: NCT06076083, data first posted: 21 November 2023) and (ID: NCT06183697, data first posted: 27 December 2023)).
Oran Wasserman, Mallory R. Wootton, Spencer Fairbanks
et al.
Summary: Solitary bee cocoons serve as protective barriers against parasitoids, yet their puncture resistance properties remain understudied. Here, we present a protocol for measuring puncture resistance in Osmia lignaria cocoons using custom 3D-printed fixtures. We describe steps for determining bee sex, preparing cocoon segments, measuring segment thickness, testing puncture resistance using 27.5-gauge sharp needles on an MTS Synergie 100 mechanical testing instrument, and analyzing the data. The protocol generates quantitative data on puncture resistance properties and thickness measurements for comparative studies. : Publisher’s note: Undertaking any experimental protocol requires adherence to local institutional guidelines for laboratory safety and ethics.
Christian Mallen, Rachel Chester, Danielle van der Windt
et al.
Introduction Musculoskeletal shoulder pain is a common reason for people to be treated in physiotherapy services, but diagnosis can be difficult and often does not guide treatment or predict outcome. People with shoulder pain cite a need for clear information, and timely, tailored consultations for their pain. This trial will evaluate the introduction of a personalised guided consultation to help physiotherapists manage care for individuals with shoulder pain.Methods and analysis This is a cluster randomised controlled trial to evaluate the clinical and cost-effectiveness of introducing a personalised guided consultation compared with usual UK NHS physiotherapy care. Physiotherapy services (n=16) will be randomised in a 1:1 ratio to either intervention (physiotherapy training package and personalised guided consultation incorporating a new prognostic tool) or control (usual care); 832 participants (416 in each arm) identified from participating physiotherapy service waiting lists aged 18 years or over with shoulder pain will be enrolled. Follow-up will occur at 3 time points: 6 weeks, 6 months and 12 months. The primary outcome will be the Shoulder Pain and Disability Index (SPADI) score over 12 months. Secondary outcomes include global perceived change of the shoulder condition, sleep, work absence and the impact of shoulder pain on work performance, healthcare utilisation and health-related quality of life (using EuroQol 5 Dimension 5 Level (EQ-5D-5L)). A multimethod process evaluation will investigate views and experiences of participants and physiotherapists, assess uptake, facilitators and barriers to delivery, and changes in factors assumed to explain intervention outcomes. Primary analysis of effectiveness will be by intention-to-treat, and a health economic evaluation will assess cost-utility of introducing the personalised consultation.Ethics and dissemination The trial received ethics approval from the Yorkshire & The Humber (South Yorkshire) Research Ethics Committee (REC reference: 23/YH/0070). Findings will be shared through journal publications, media outlets and conference presentations. Supported by patient contributors and clinical advisors, we will communicate findings through a designated website, networks, newsletters, leaflets and in the participating physiotherapy services.Trial registration number ISRCTN45377604.
Mitsuo P. Sato, Austin P. Huang, Stefan Heller
et al.
Summary: The avian inner ear can naturally regenerate sensory hair cells and is therefore an ideal candidate for investigating mechanisms leading to hair cell regeneration and functional recovery. Here, we present a surgical protocol for eliminating auditory hair cells via sisomicin injection into the lateral semicircular canal. We describe steps for multiplex mRNA detection in chicken basilar papilla and utricle sections. We then detail procedures for integrating immunohistochemistry for concurrent mRNA and protein visualization, complemented by S-phase labeling with EdU.For complete details on the use and execution of this protocol, please refer to Benkafadar et al., Benkafadar et al., Sato et al., Janesick et al., Scheibinger et al.1,2,3,4,5 : Publisher’s note: Undertaking any experimental protocol requires adherence to local institutional guidelines for laboratory safety and ethics.
Effective communication occurs if students understand the meaning of the message conveyed by the teacher. If the delivery made by the teacher is not good, there will be a misunderstanding. This study aims to analyse how a Christian teacher can help students learn to communicate effectively. A descriptive qualitative research methodology utilizing literature studies was employed. In the era of postmodernism presenting various truths in assessing the actions taken, it is hoped that Christian teachers will be able to have the right foundation in acting. So, it is possible to build effective communication so that teachers, serving as guides, can understand and appreciate the needs of students, use media, explain messages clearly, and be humble. The conclusion is that Christian teachers as guides can have the right value of truth in building effective communication, namely looking at students as images of God. This is in line with the characteristic of Christian ethics, namely love. So, Christian teachers can love students so that they develop their abilities as a form of responsibility for the potential given by God. One of the ways that teachers do this is by choosing words in delivering messages to students related to assignments. The advice given is to choose a theory that is relevant to effective communication problems in learning so that it can analyze more deeply and find concrete solutions that can be applied to the role of teachers as guides.
Bahasa Indonesia Abstract
Komunikasi yang efektif terjadi ketika siswa memahami maksud dari pesan yang disampaikan oleh guru. Jika penyampaian yang dilakukan oleh guru tidak baik, maka akan terjadi kesalahpahaman. Penelitian ini bertujuan untuk menganalisa bagaimana seorang guru Kristen dapat membantu murid-muridnya untuk belajar berkomunikasi secara efektif. Metodologi yang digunakan dalam penelitian ini adalah kualitatif deskriptif dengan menggunakan studi literatur. Di era postmodernisme yang menghadirkan berbagai kebenaran dalam menilai tindakan yang dilakukan, diharapkan para guru Kristen dapat memiliki dasar yang benar dalam bertindak. Dengan demikian, dimungkinkan untuk membangun komunikasi yang efektif sehingga guru yang berperan sebagai penuntun dapat memahami dan menghargai kebutuhan siswa, menggunakan media, menjelaskan pesan dengan jelas, dan rendah hati. Kesimpulannya adalah guru Kristen sebagai penuntun dapat memiliki nilai kebenaran yang tepat dalam membangun komunikasi yang efektif, yaitu memandang siswa sebagai gambar Allah. Hal ini sejalan dengan ciri khas etika Kristen, yaitu kasih. Jadi, guru Kristen dapat mengasihi murid agar mereka mengembangkan kemampuannya sebagai bentuk tanggung jawab atas potensi yang diberikan Tuhan. Salah satu cara yang dilakukan guru adalah dengan memilih kata-kata dalam menyampaikan pesan kepada siswa terkait tugas. Saran yang diberikan adalah memilih teori yang relevan dengan masalah komunikasi efektif dalam pembelajaran sehingga dapat menganalisa lebih dalam dan menemukan solusi konkrit yang dapat diterapkan pada peran guru sebagai penuntun.
Christianity, Practical religion. The Christian life
Amani Thomas Mori, Amani Thomas Mori, Amani Thomas Mori
et al.
BackgroundNearly 100 million people are pushed into poverty every year due to catastrophic health expenditures (CHE). We evaluated the impact of cash support programs on healthcare utilization and CHE among households participating in a cluster-randomized controlled trial focusing on adolescent childbearing in rural Zambia.Methods and findingsThe trial recruited adolescent girls from 157 rural schools in 12 districts enrolled in grade 7 in 2016 and consisted of control, economic support, and economic support plus community dialogue arms. Economic support included 3 USD/month for the girls, 35 USD/year for their guardians, and up to 150 USD/year for school fees. Interviews were conducted with 3,870 guardians representing 4,110 girls, 1.5–2 years after the intervention period started. Utilization was defined as visits to formal health facilities, and CHE was health payments exceeding 10% of total household expenditures. The degree of inequality was measured using the Concentration Index. In the control arm, 26.1% of the households utilized inpatient care in the previous year compared to 26.7% in the economic arm (RR = 1.0; 95% CI: 0.9–1.2, p = 0.815) and 27.7% in the combined arm (RR = 1.1; 95% CI: 0.9–1.3, p = 0.586). Utilization of outpatient care in the previous 4 weeks was 40.7% in the control arm, 41.3% in the economic support (RR = 1.0; 95% CI: 0.8–1.3, p = 0.805), and 42.9% in the combined arm (RR = 1.1; 95% CI: 0.8–1.3, p = 0.378). About 10.4% of the households in the control arm experienced CHE compared to 11.6% in the economic (RR = 1.1; 95% CI: 0.8–1.5, p = 0.468) and 12.1% in the combined arm (RR = 1.1; 95% CI: 0.8–1.5, p = 0.468). Utilization of outpatient care and the risk of CHE was relatively higher among the least poor than the poorest households, however, the degree of inequality was relatively smaller in the intervention arms than in the control arm.ConclusionsEconomic support alone and in combination with community dialogue aiming to reduce early childbearing did not appear to have a substantial impact on healthcare utilization and CHE in rural Zambia. However, although cash transfer did not significantly improve healthcare utilization, it reduced the degree of inequality in outpatient healthcare utilization and CHE across wealth groups.Trial Registrationhttps://classic.clinicaltrials.gov/ct2/show/NCT02709967, ClinicalTrials.gov, identifier (NCT02709967).
Mikhaila N. Layshock, Amy S. Porter, Jori F. Bogetz
et al.
Objective: To better understand the strategies family caregivers of children with medical complexity (CMC) utilize to deal with the stress and challenges associated with caregiving. Methods: We conducted a cross-sectional qualitative study among family caregivers of CMC receiving medical care at a children’s hospital in Western Pennsylvania. Participants completed in-depth, semi-structured interviews focused on how CMC family caregivers approach and manage caregiving-related challenges and stress. Using constant comparative methodology, we inductively analyzed deidentified transcripts for emergent themes. Results: We interviewed 19 participants (89.4% female) with a mean age of 43 years (range 32–54 years). The mean age of the participants’ children was 10.8 years (range 1–20 years). Twelve participants’ children identified as white and four identified as Black. Three central themes regarding CMC caregivers’ stress-coping strategies emerged: (1) maintaining a positive mindset, (2) developing and relying on interpersonal support networks, and (3) making time for self-preservation. All three themes were universally reported (<i>n</i> = 19/19) by our participants. The most common subthemes for each theme, respectively, focused on staying hopeful and celebrating moments of joy; cultivating supportive relationships with family, friends, and fellow CMC family caregivers; and finding pleasure in “little things” (e.g., everyday activities and hobbies). Conclusion: Family caregivers of CMC utilize a multi-faceted approach to cope with the stress and challenges routinely encountered in caring for CMC. This study’s findings could be used to inform future clinical efforts and research directions aiming to improve clinicians’ ability to support CMC caregivers’ well-being.
Abstract
The code of ethics of the EPA intends to guide the ethical practice of psychiatry by offering a comprehensive approach to the ethical challenges in the field. It highlights universal ethical principles and considers their application to the specific practice of psychiatry. Ethical questions in psychiatric practice are manifold: tensions between respect for autonomy versus care and protection from harm, problems with coercive therapy and capacity for judgement etc. To receive more information, the Committee on Ethical Issues conducted a survey on “Ethics in psychiatric practice” to collect information from inpatient treatment settings of individual wards in psychiatric hospitals Europe-wide on following topics:
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Experiences and practices addressing ethical conflicts and malpractice from the personal perspective of health care workers in these settings
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Identification and engagement with violence
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Measures for the reduction of restraints and coercion (violation of the autonomy of patients)
In this talk, the preliminary results of this survey will be presented and discussed.
Disclosure of Interest
None Declared
This article reviews the literature on how religious leaders in Nigeria have become complacent and conspire in the
corrupt activities of members of their congregations. Church leaders, who are meant to be guardians of ethics and morality, have lost it and are now dining with and covering people of dubious character. Some of these young people who engage in money rituals give money to these pastors, who accept it without inquiry. These young people are revered in the church and receive special prayers and honours. Others, who aspire to the same honours, seek ways to generate quick cash. This study investigates the role of church leaders in the growing ritual activities among Nigerian youths. It concludes by admonishing church leaders to emulate the life of Jesus, who was not afraid to speak the truth to the people whom
he was shepherding.
Christianity, Practical religion. The Christian life
Guillemette Lienhart, Beatrice Thivichon-Prince, Pierre Farge
et al.
Introduction Dental caries is one of the most common non-communicable diseases in children. The disease management of caries relies on both a preventive individual approach (fluoridation, risk evaluation) and the surgical treatment of established carious lesions. Similar to other non-communicable diseases (obesity, mental diseases, etc), health professionals’ negative perceptions of patients have been shown to affect the quality of disease management. Regarding dental caries in children, some data have indicated the presence of discriminating beliefs and behaviours towards these children and their families in the medical setting. However, oral health stigma related to dental care remains a largely unexplored issue.Methods and analysis This study presents an exploratory research protocol focusing on the perceptions and attitudes of health professionals towards children with early childhood caries (ECC) and their parents. Semistructured interviews will be conducted among medical and dental health professionals, and verbatim quotations obtained from audio transcriptions will be analysed to identify health professionals’ perceptions of ECC and the influence of these perceptions on clinical care for these children.Ethics and dissemination The research ethics committee of the Department of Family Medicine at University Lyon 1 approved this protocol. The results will be published in peer-reviewed journals and presented at scientific meetings.Trial registration number NCT05284279.