Recovered or Not Recovered? A First Person Narrative Case for Non-Abstinent Recovery.

Purpose: The purpose of this paper was to explore interlocking questions relating to how we deal with drugs and medication in crisis residential mental health settings. In particular, it examines issues related to overly medical and simplistic explanations of the relationship between cannabis and psychosis, the positive effects of drugs, the effects of having standard rules for diverse groups of people and the concept of non-abstinent recovery.

Background: I have used mental health and addiction services for 25 years and I have 6 years' experience as a peer worker, working with many people who use drugs.

Agronomic and economic implications of cover crop and phosphorus fertilizer management practices for water quality improvement.

Phosphorus (P) fertilization practices and winter cover crops are promoted to protect water quality yet can potentially influence crop yield and profitability. This study examined the impacts of three P fertilizer management practices (no P, fall broadcast P, and spring injected P) and winter annual cover crop use on yields, net returns, and water quality in a no-till corn-soybean rotation. Treatments were replicated in a 4-yr field study where sediment, total P, and dissolved reactive P (DRP) losses in edge-of-field surface runoff were continuously monitored.

The effect of do-it-yourself real-time continuous glucose monitoring on psychological and glycemic variables in children with type 1 diabetes: A randomized crossover trial.

Background: Continuous glucose monitoring (CGM) decreases fear of hypoglycemia (FOH) and improves glycemic control among those affected by type 1 diabetes (T1D). No studies to date have examined the impact of using do-it-yourself real-time continuous glucose monitoring (DIY RT-CGM) on psychological and glycemic outcomes.

Methods: Child-parent dyads were recruited for a multicentre randomized crossover trial.

Use of intermittently scanned continuous glucose monitoring in young people with high-risk type 1 diabetes-Extension phase outcomes following a 6-month randomized control trial.

Aims: To describe the impact of a 12-month intervention using intermittently scanned continuous glucose monitoring (isCGM) on glycaemic control and glucose test frequency in adolescents and young adults with type 1 diabetes (T1D) and high-risk glycaemic control (HbA ≥75 mmol/mol [≥9.0%]).

Methods: In total, 64 young people (aged 13-20 years, 16.

Parental experiences of short term supported use of a do-it-yourself continuous glucose monitor (DIYrtCGM): A qualitative study.

Aims: To investigate the experiences of parents caring for young children with type 1 diabetes type 1 diabetes using a do-it-yourself continuous glucose monitor (DIYrtCGM) in a supported setting.

Methods: Exit interviews were conducted with parents from 11 families at the end of the MiaoMiao study: a randomised cross-over trial focusing on parental fear of hypoglycaemia. Technical support was provided to participants while using DIYrtCGM during the trial.

Cover crop and phosphorus fertilizer management impacts on surface water quality from a no-till corn-soybean rotation.

Best management practices that reduce potential phosphorus (P) loss and provide flexibility in P fertilizer management are needed to help producers protect water quality while maintaining crop yield. This study examined the impacts of P fertilizer management (no P, fall broadcast P, and spring injected P) and cover crop use on annual concentrations and loads of sediment, total P, and dissolved reactive P (DRP) in edge-of-field runoff from a no-till corn (Zea mays)-soybean (Glycine max) rotation in the Central Great Plains, USA, from September 2015 through September 2019. The spring injected P fertilizer treatment generally had 19% less total P and 33% less DRP loss compared to the fall broadcast treatment, confirming the importance of P fertilizer management as a practice for reducing P loss.

The MiaoMiao study: can do-it-yourself continuous glucose monitoring technology improve fear of hypoglycaemia in parents of children affected by type 1 diabetes?

Purpose: Type 1 diabetes (T1D) is one of the most common chronic diseases of childhood and comes with considerable management and psychological burden for children and their families. Fear of hypoglycaemia (FOH), particularly nocturnal hypoglycaemia, is a common worry. Continuous glucose monitoring (CGM) is a tool that may help reduce FOH, as well as reduce overall diabetes burden.

Evaluation of winter pressures on general practice in Manchester: a cross-sectional analysis of nine GP practices.

Background: The Nuffield Trust's report on NHS winter pressures highlights a lack of data for primary care, with a consequential focus on secondary care. An increase in data is required on the scale of the winter demand on primary care, so the need for investment in this area can be clearly seen.

Aim: To quantify seasonal variation in workload in primary and secondary care.

Cutaneous adverse events in a randomized controlled trial of flash glucose monitoring among youth with type 1 diabetes mellitus.

Background: The literature regarding flash glucose monitoring (FGM)-associated cutaneous adverse events (AE) is limited.

Objectives: This study among youth participating in a 6 month randomized controlled trial aimed to compare cutaneous AE between FGM and self-monitored blood glucose (SMBG) use and evaluate premature FGM sensor loss.

Methods: Patients aged 13 to 20 years with type 1 diabetes were randomized to intervention (FGM and usual care) or control (SMBG and usual care).

A narrative of my lived experience of a whole series of psychiatric diagnoses and their impacts on me, ending with a discussion of clinical recovery from psychosis.

WHAT IS KNOWN ON THE SUBJECT?: All health service users in Belgium have the right to be informed about their diagnosis. There is a whole spectrum of prognoses for psychosis, but many practitioners show a bias towards believing that psychosis is always regressive. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This paper is a first person narrative of one thread through my experiences as a mental health service user: the story of my diagnoses.

Effect of 6 Months of Flash Glucose Monitoring in Youth With Type 1 Diabetes and High-Risk Glycemic Control: A Randomized Controlled Trial.

Objective: To investigate whether intermittently scanned continuous glucose monitoring (isCGM) significantly improves glycemic control compared with capillary self-monitored blood glucose (SMBG) in youth with type 1 diabetes and high-risk glycemic control.

Research Design And Methods: This multicenter 6-month randomized, controlled, parallel-arm trial included 64 participants aged 13-20 years with established type 1 diabetes and glycated hemoglobin (HbA) ≥9% (≥75 mmol/mol). Participants were allocated to 6-month intervention (isCGM; FreeStyle Libre; Abbott Diabetes Care, Witney, U.

Initial experiences of adolescents and young adults with type 1 diabetes and high-risk glycemic control after starting flash glucose monitoring - a qualitative study.

Purpose: This study explored early experiences with a flash glucose monitoring system among adolescents and young adults with type 1 diabetes and high-risk glycemic control.

Methods: Adolescents and young adults with high-risk glycemic control (HbA1c ≥ 75 mmol/mol (9.0%) in the previous 6 months) who had recently commenced on flash glucose monitoring as part of a trial took part in a semi-structured interview exploring their experiences with the technology.

The 'flash' adhesive study: a randomized crossover trial using an additional adhesive patch to prolong freestyle libre sensor life among youth with type 1 diabetes mellitus.

Aims: Although strategies to prevent premature sensor loss for flash glucose monitoring (FGM) systems may have substantial benefit, limited data are available. This study among youth with high-risk type 1 diabetes evaluated whether an additional adhesive patch over FGM sensors would reduce premature sensor loss frequency and not cause additional cutaneous adverse events (AEs).

Methods: This is a six-month, open-label, randomized crossover trial.

Truncation of Pik3r1 causes severe insulin resistance uncoupled from obesity and dyslipidaemia by increased energy expenditure.

Objective: Insulin signalling via phosphoinositide 3-kinase (PI3K) requires PIK3R1-encoded regulatory subunits. C-terminal PIK3R1 mutations cause SHORT syndrome, as well as lipodystrophy and insulin resistance (IR), surprisingly without fatty liver or metabolic dyslipidaemia. We sought to investigate this discordance.

A qualitative exploration of service users' and staff members' perspectives on the roles of inpatient settings in mental health recovery.

Background: Today, international mental health care increasingly focuses on creating recovery-oriented systems of support. This study aims to unravel the daily practice of an inpatient psychiatric ward that engages with persons with complex mental health needs.

Methods: 17 in-depth interviews were conducted with patients and staff of the ward.

Biallelic variants in EFEMP1 in a man with a pronounced connective tissue phenotype.

Connective tissue disorders are a spectrum of diseases that affect the integrity of tissues including skin, vasculature, and joints. They are often caused by variants that disrupt genes encoding components of extracellular matrix (ECM). The fibulin glycoproteins are ECM proteins important for integrity of tissues including dermis, retina, fascia, and vasculature.

Exploring parental perspectives after commencement of flash glucose monitoring for type 1 diabetes in adolescents and young adults not meeting glycaemic targets: a qualitative study.

Aims: To explore parental perspectives after flash glucose monitoring commencement in adolescents and young adults with type 1 diabetes who were not meeting glycaemic targets.

Methods: Twelve semi-structured interviews were conducted among parents of adolescents and young adults between the ages of 14 and 20 years (inclusive) with type 1 diabetes and not meeting glycaemic targets [HbA 81-130 mmol/mol (9.6-14.

Evaluating the impact of an insulin pump discontinuation action plan on patient or caregiver confidence and anxiety.

Aims: Insulin pump failure and adverse events are common and therefore anticipatory education is recommended. Research in other chronic diseases shows written action plans improve confidence and adherence during an acute deterioration. However, no similar data exists for patients with type one diabetes mellitus provided with anticipatory education via an insulin pump action plan.

A nurse-led rheumatology telephone advice line: service redesign to improve efficiency and patient experience.

Background: nurse-led telephone advice line (TAL) services have been endorsed by the Royal College of Nursing (RCN) and provide patients and their carers with expert advice and self-management strategies. Identified helpline shortfalls in one rheumatology TAL included a high number of inappropriate calls, calls not recorded in patients' records, and no formal process for assigning calls to nurses. Using RCN guidelines, the service was redesigned by specialist rheumatology nurses to address these issues.

Effect of 6 months' flash glucose monitoring in adolescents and young adults with type 1 diabetes and suboptimal glycaemic control: managing diabetes in a 'flash' randomised controlled trial protocol.

Background: Teenagers and young adults with type 1 diabetes (T1D) experience significant burden managing this serious chronic condition and glycaemic control is at its unhealthiest during this life stage. Flash glucose monitoring (FGM) is a new technology that reduces the burden of glucose monitoring by easily and discreetly displaying glucose information when an interstitial glucose sensor worn on the upper arm is scanned with a handheld reader, as opposed to traditional capillary glucose sampling by finger prick (otherwise known as self-monitored blood glucose, SMBG). The effectiveness of this technology and impacts of its long-term use in youth with pre-existing suboptimal glycaemic control are unknown.

Complex reproductive secretions occur in all extant gymnosperm lineages: a proteomic survey of gymnosperm pollination drops.

Complex protein-containing reproductive secretions are a conserved trait amongst all extant gymnosperms; the pollination drops of most groups include carbohydrate-modifying enzymes and defence proteins. Pollination drops are aqueous secretions that receive pollen and transport it to the ovule interior in gymnosperms (Coniferales, Cycadales, Ginkgoales, Gnetales). Proteins are well established as components of pollination drops in conifers (Coniferales) and Ephedra spp.

Cracking the omega code: hydraulic architecture of the cycad leaf axis.

Background And Aims: The leaf axis of members of the order Cycadales ('cycads') has long been recognized by its configuration of independent vascular bundles that, in transverse section, resemble the Greek letter omega (hence the 'omega pattern'). This provides a useful diagnostic character for the order, especially when applied to paleobotany. The function of this pattern has never been elucidated.

Whole-exome sequencing of 228 patients with sporadic Parkinson's disease.

Parkinson's disease (PD) is the most common neurodegenerative movement disorder, affecting 1% of the population over 65 years characterized clinically by both motor and non-motor symptoms accompanied by the preferential loss of dopamine neurons in the substantia nigra pars compacta. Here, we sequenced the exomes of 244 Parkinson's patients selected from the Oxford Parkinson's Disease Centre Discovery Cohort and, after quality control, 228 exomes were available for analyses. The PD patient exomes were compared to 884 control exomes selected from the UK10K datasets.