National audit of non-melanoma skin cancer excisions performed by plastic surgery in the UK

A national, multi-centre audit of non-melanoma skin cancer excisions by plastic surgery.

A-46 Impairments in Memory for “Who”, “When”, and “Where” are Detectable in Middle-Aged Adults

Objective

We conducted a cross-sectional study to examine age-¬related differences in performance on a new test assessing memory for “who, when, and where” and associations among these elements. The test was designed to assess aspects of episodic memory by simulating an everyday experience of meeting a series of different people in different places across time.

Method

Healthy young (ages 18¬-25), middle-aged (ages 40-55), and older adults (ages 60+) were asked to remember a sequence of pictures of different faces paired with different places. After viewing the sequence, the participants were asked to pair each face with the correct place and put the face-place pairs in the correct sequence. Participants also completed a battery of standardized neuropsychological tests.

Results

Young adults remembered significantly more face-place pairs in the correct sequence than middle-aged (p < .05) and older adults (p < .05). There were no significant differences between middle-aged and older adults in the number of face-place pairs in correct sequence. Furthermore, young adults remembered significantly more face-place pairs irrespective of sequence than older adults (p < .05). There were no significant differences between young and middle-aged adults or between middle-aged and older adults in the number of correct face-place pairs irrespective of sequence.

Conclusions

Using a new test that incorporates aspects of episodic memory, we found evidence for age-related differences in test performance beginning in middle age. We found that performance on the test correlated with performance on standardized measures of verbal memory and executive functioning but not visual confrontation naming.

Cultivating the compassionate self against depression: An exploration of processes of change

Introduction

Compassion and self-compassion can be protective factors against mental health difficulties, in particular depression. The cultivation of the compassionate self, associated with a range of practices such as slow and deeper breathing, compassionate voice tones and facial expressions, and compassionate focusing, is central to compassion focused therapy (Gilbert, 2010). However, no study has examined the processes of change that mediate the impact of compassionate self-cultivation practices on depressive symptoms.

Aims

The aim of this study is to investigate the impact of a brief compassionate self training (CST) intervention on depressive symptoms, and explore the psychological processes that mediate the change at post intervention.

Methods

Using a longitudinal design, participants (general population and college students) were randomly assigned to one of two conditions: Compassionate self training (n = 56) and wait-list control (n = 37). Participants in the CST condition were instructed to practice CST exercises for 15 minutes everyday or in moments of stress during two weeks. Self-report measures of depression, self-criticism, shame and compassion, were completed at pre and post in both conditions.

Results

Results showed that, at post-intervention, participants in the CST condition decreased depression, self-criticism and shame, and increased self-compassion and openness to receive compassion from others. Mediation analyses revealed that changes in depression from pre to post intervention were mediated by decreases in self-criticism and shame, and increases in self-compassion and openness to the compassion from others.

Conclusions

These findings support the efficacy of compassionate self training components on lessening depressive symptoms and promoting mental health.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Fears of compassion and happiness in relation to alexithymia, mindfulness, and self-criticism

BACKGROUND

There is increasing research to suggest that fears of, and resistances to, affiliative and positive emotions are linked to self-criticism and a range of psychopathologies. It is unclear how these fears and resistances are linked to each other and how these in turn are linked to psychological processes, such as abilities to be mindful and recognize and describe emotions.

OBJECTIVES

This research explores the relationship between fears of compassion and happiness in general, with capacities for emotional processing (alexithymia), capacities for mindfulness, and empathic abilities. To advance this research, a new scale was developed to measure general fears of positive feelings - the Fear of Happiness Scale.

RESULTS

The results showed that fears of compassion for self, from others and in particular fear of happiness, were highly linked to different aspects of alexithymia, mindfulness, empathy, self-criticism and depression, anxiety and stress. Especially noteworthy was the very high correlation between fear of happiness and depression (r= .70).

CONCLUSION

While the development of positive emotions, especially those linked to affiliation and connectedness are increasingly seen as important therapeutic targets, little research has focused on the blocks and fears to positive emotions. This study used newly developed fears of positive affect scales (e.g., compassion and happiness) to explore these aspects and found they were significantly linked to psychopathology variables self-criticism and difficulties such as alexithymia.

Problems in identifying predictors and correlates of weight loss and maintenance: implications for weight control therapies based on behaviour change

Weight management is a dynamic process, with a pre-treatment phase, a treatment (including process) phase and post-treatment maintenance, and where relapse is possible during both the treatment and maintenance. Variability in the statistical power of the studies concerned, heterogeneity in the definitions, the complexity of obesity and treatment success, the constructs and measures used to predict weight loss and maintenance, and an appreciation of who and how many people achieve it, make prediction difficult. In models of weight loss or maintenance: (i) predictors explain up to 20-30% of the variance; (ii) many predictors are the sum of several small constituent variables, each accounting for a smaller proportion of the variance; (iii) correlational or predictive relationships differ across study populations; (iv) inter-individual variability in predictors and correlates of outcomes is high and (v) most of the variance remains unexplained. Greater standardization of predictive constructs and outcome measures, in more clearly defined study populations, tracked longitudinally, is needed to better predict who sustains weight loss. Treatments need to develop a more individualized approach that is sensitive to patients' needs and individual differences, which requires measuring and predicting patterns of intra-individual behaviour variations associated weight loss and its maintenance. This information will help people shape behaviour change solutions to their own lifestyle needs.

An Ad5-vectored HIV-1 vaccine elicits cell-mediated immunity but does not affect disease progression in HIV-1-infected male subjects: results from a randomized placebo-controlled trial (the Step study)

BACKGROUND

The Step study was a randomized trial to determine whether an adenovirus type 5 (Ad5) vector vaccine, which elicits T cell immunity, can lead to control of human immunodeficiency virus (HIV) replication in participants who became HIV-infected after vaccination.

METHODS

We evaluated the effect of the vaccine on trends in HIV viral load, CD4+ T cell counts, time to initiation of antiretroviral therapy (ART), and AIDS-free survival in 87 male participants who became infected with HIV during the Step study and who had a median of 24 months of post-infection follow-up.

RESULTS

There was no overall effect of vaccine on mean log(10) viral load (estimated difference between groups, -0.11; P = .47). In a subset of subjects with protective HLA types (B27, B57, B58), mean HIV-1 RNA level over time was lower among vaccine recipients. There was no significant difference in CD4+ T cell counts, time to ART initiation, or in AIDS-free survival between HIV-1-infected subjects who received vaccine versus those who received placebo.

CONCLUSIONS

HIV RNA levels, CD4+ T cell counts, time to initiation of ART, and AIDS-free survival were similar in vaccine and placebo recipients. There may have been a favorable effect of vaccine on HIV-1 RNA levels in participants with HLA types associated with better control of HIV-1.

Acne: A biopsychosocial and evolutionary perspective with a focus on shame

PURPOSE

Hypotheses regarding the psychological factors implicated in the development and maintenance of acne first emerged in the middle of the eighteenth century. However, the psychodermatological literature from this date relating to acne has variously been described as confusing, overly prone to conjecture and, in particular, atheoretical. The current paper has two key objectives; first, to present a biopsychosocial model of acne development and maintenance and, secondly, to understand the psychosocial strain imposed by acne from an evolutionary perspective with a particular emphasis on body shame reactions.

METHODS

The psychodermatological literature relating to acne is reviewed with the data analysed for potential biopsychosocial interactions and shame eliciting responses.

RESULTS

The review indicates that acne can be reconceptualized as a biopsychosocial phenomena which, in turn, provides the field with innovative hypotheses for empirical inquiry and the potential for expanding and evaluating treatment options. The evolutionary analysis illustrates that acne provides the potential for distressing body shame reactions due to the skin disease's potential for damaging self-other evaluations of attractiveness.

CONCLUSIONS

Acne has tended to be viewed as a minor dermatological complaint which imposes minimal psychological distress upon sufferers. The paper concludes that acne has the ability to elicit in some sufferers significant mental health concerns due to a heightened sense of shame relating to appearance.

Antinociceptive effects of epidural buprenorphine or medetomidine, or the combination, in conscious cats

The aim of this study was to compare the antinociceptive effects of epidural buprenorphine (EB), epidural medetomidine (EM) or epidural buprenorphine-medetomidine (EBM). Eight cats were studied. Thermal thresholds (TT) were measured by increasing the temperature of a probe placed on the thorax. Mechanical thresholds (MT) were measured through inflation of a modified blood pressure bladder to the cat's forelimb. After baseline measurements, EB (0.02 mg/kg), EM (0.01 mg/kg) or half of the doses of each drug (EBM) were administered. Data were analysed using anova (P < 0.05) and 95% confidence interval (CI). TT increased from 30 min to 1 h after EB and at 45 min after EM. MT increased from 45 min to 2 h after EB, from 15 min to 1 h after EM and at 30, 45 min and at 2 h after EBM. MT were significantly lower after EB than EM at 30 min. TT were above the upper 95%CI from 15 min to 24 h after EB, from 15 min to 4 h after EM and from 15 min to 8 h after EBM. MT were above the upper 95%CI from 15 min to 5 h, and at 8, 12 and 24 h after EB, from 15 min to 6 h after EM and from 15 min to 6 h and at 12 and 24 h after EBM. All treatments had similar onset. Overall, EB presented longer period of action than EBM and EM. The same magnitude of analgesia was achieved, but with fewer side effects when EBM was compared with EM.

Tar reduction in pyrolysis vapours from biomass over a hot char bed

The behaviour of pyrolysis vapours over char was investigated in order to maximise tar conversion for the development of a new fixed bed gasifier. Wood samples were decomposed at a typical pyrolysis temperature (500 degrees C) and the pyrolysis vapours were then passed directly through a tar cracking zone in a tubular reactor. The product yields and properties of the condensable phases and non-condensable gases were studied for different bed lengths of char (0-450 mm), temperatures (500-800 degrees C), particle sizes (10 and 15 mm) and nitrogen purge rates (1.84-14.70 mm/s). The carbon in the condensable phases showed about 66% reduction by a 300 mm long char section at 800 degrees C, compared to that for pyrolysis at 500 degrees C. The amount of heavy condensable phase decreased with increasing temperature from about 18.4 wt% of the biomass input at 500 degrees C to 8.0 wt% at 800 degrees C, forming CO, H(2) and other light molecules. The main mode of tar conversion was found to be in the vapour phase when compared to the results without the presence of char. The composition of the heavy condensable phase was simplified into much fewer secondary and tertiary tar components at 800 degrees C. Additional measures were required to maximise the heterogeneous effect of char for tar reduction.

Development of an early memories of warmth and safeness scale and its relationship to psychopathology

Experiences of early childhood have a major impact on physiological, psychological, and social aspects of maturation and functioning. One avenue of work explores the recall and memory of positive or negative rearing experiences and their association with psychopathology measures. However, while many self-report studies have focused on the recall of parental behaviours this study developed a new measure called the early memories of warmth and safeness scale (EMWSS), which focuses on recall of one's own inner positive feelings, emotions and experiences in childhood. Student participants (N = 180) completed the new scale and a series of self-report scales measuring different types of early recall, psychopathology, types of positive affect, and self-criticism/reassurance. The EMWSS was found to have good psychometric properties and reliability. Recall of parental behaviour and recall of positive emotional memories were highly related, but recall of positive emotional memories was a better predictor of psychopathology, styles of self-criticism/self-reassurance and disposition to experience positive affect, than recall of parental behaviour.

Trifluorthymidine in the treatment of herpes simplex corneal ulcers. A clinical evaluation

The treatment of herpetic corneal ulcerations with trifluorthymidine (F3T) has been evaluated in a clinical trial. F3T was found to be an effective antiviral agent for herpetic keratitis and a valuable alternative to idoxuridine (IDU)-therapy. Clinically IDU-resistent herpetic ulcers responded favourably to treatment with F3T.

Senescence can explain microbial persistence

It has been known for many years that small fractions of persister cells resist killing in many bacterial colony-antimicrobial confrontations. These persisters are not believed to be mutants. Rather it has been hypothesized that they are phenotypic variants. Current models allow cells to switch in and out of the persister phenotype. Here, a different explanation is suggested for persistence, namely senescence. Using a mathematical model including age structure, it is shown that senescence provides a natural explanation for persistence-related phenomena, including the observations that the persister fraction depends on growth phase in batch culture and dilution rate in continuous culture.

Common therapeutic approaches for the control of oral biofilms: microbiological safety and efficacy

Triclosan is widely employed in many consumer and healthcare products. The increasing employment of triclosan in a range of consumer products where there is no proven benefit for hygiene has been severely criticised. Laboratory studies demonstrate theoretical risks that the wide-scale use of triclosan might compromise its efficacy as well as the activity of third-party antibiotics. The precautionary principle would dictate against the use of triclosan, at least in those products where there was no demonstrable health benefit. The theoretical risks, however, are not supported by either field or clinical studies, or by laboratory studies using bacterial microcosms. Numerous clinical studies, as well as historical data, demonstrate the clinical benefits of hygiene adjuncts such as triclosan and triclosan/copolymer in oral care products where these compensate for deficiencies in mechanical hygiene (brushing and flossing). The balance of risk and benefit is firmly in favour of the continued use of dentifrices (toothpastes) and mouthwashes containing active agents such as triclosan.