‘Outside the Original Remit’: Co‐production in UK mental health research,lessons from the field

The aim of this discursive paper was to explore the development of co‐production and service user involvement in UK university‐based mental health research and to offer practical recommendations for practitioners co‐producing research with service users and survivors, informed by an overview of the key literature on co‐production in mental health and from a critical reflection on applied research through the medium of a case study. The paper is co‐written by a mental health nurse academic and a service user/survivor researcher academic. The authors argue that the implications of co‐production for mental health research remain underexplored, but that both the practitioner and service user/survivor researcher experience and perspective of co‐production in research can provide practical reflections to inform developing research practice. The theories and values of emancipatory research can provide a framework from which both practitioners and service users can work together on a research project, in a way that requires reflection on process and power dynamics. The authors conclude that whilst co‐produced investigations can offer unique opportunities for advancing emancipatory and applied research in mental health, practitioner researchers need to be more radical in their consideration of power in the research process.     

Paths to sustainable wood supply to the pulp and paper industry in Indonesia after diseases have forced a change of species from acacia to eucalypts

In Sumatra and Kalimantan in Indonesia and Sabah in Malaysia, the spread of two diseases, aggravated by damage by fauna, and by the humid tropical environment, has forced a change of planted species from Acacia mangium to Eucalyptus pellita and related interspecific hybrids, at a scale unprecedented in the history of plantation forestry. This experience highlights the risks of relying on any single species for large contiguous plantation estates in environments with endemic biotic and abiotic stresses. There is a need to transition to multiple-species plantation forestry, adopting the opportunities for changeover of species and varieties in short-rotation systems. Industry’s responses for coping with this rapid change have been helped by earlier collaborative research on acacia which promoted management practices that conserved site resources and avoided site degradation during the critical harvesting and inter-rotation phase. The current growth rates of E. pellita and its hybrids are lower than that of A. mangium. Estimates of production from plantations and expanding capacity of the pulp and paper mills highlight a risk of significant shortfalls in wood production. Improving the quality and consistency of forest operations and revision and refocussing of research and development are critical to set and achieve realistic targets for stable, incremental improvements in productivity. Each company should consider investing systematically in contemporary adaptive research for developing and applying integrated management practices that are efficient and feasible on large scales and suitable for their circumstances. There is also a critical need for research to understand the dynamics of local human capital and its relationships with the forestry sector, with focus on improving access to a stable labour force.     

Functional Electrical Stimulation—A New Therapeutic Approach to Enhance Exercise Intensity in Chronic Obstructive Pulmonary Disease Patients: A Randomized,Controlled Crossover Trial

Objective

To evaluate the effect of quadriceps functional electrical stimulation (FES)-cycling on exertional oxygen uptake ($\dot{\text{V}}$o₂) compared with placebo FES-cycling in patients with chronic obstructive pulmonary disease (COPD).

生活方式与非药物调脂

目的:通过养成饮用牛奶并坚持有氧运动的生活方式,探讨非药物调脂的途径。方法:体检的32名血脂异常者(排除后),并将其血脂数据作为首次检测数据。采取早餐饮用纯牛奶,3个月后复查血脂;继续饮用该奶品,同时坚持有氧运动3个月,再行血脂检测,将以上两组数据分别与首次检测数据进行对比分析。结果:第二次检测数据与原始数据之间差异仅部分有统计学意义(P<0.05),第三次检测数据与原始数据间差异大部分有统计学意义(P<0.05)。结论:通过本项研究,初步认为单纯饮用牛奶,调脂作用有限,坚持饮用牛奶并配合有氧运动,调脂作用明显,多种健康生活方式对血脂的改善可能具有协同效应。     

Calendering as a direct shaping tool for the continuous production of fixed-dose combination products via co-extrusion

In this study calendering is used as a downstream technique to shape monolithic co-extruded fixed-dose combination products in a continuous way. Co-extrudates with a metoprolol tartrate-loaded sustained-release core and a hydrochlorothiazide-loaded immediate-release coat were produced and immediately shaped into a monolithic drug delivery system via calendering, using chilled rolls with tablet-shaped cavities. In vitro metoprolol tartrate release from the ethylcellulose core of the calendered tablets was prolonged in comparison with the sustained release of a multiparticulate dosage form, prepared manually by cutting co-extrudates into mini-matrices. Analysis of the dosage forms using X-ray micro-computed tomography only detected small differences between the pore structure of the core of the calendered tablet and the mini-matrices. Diffusion path length was shown to be the main mechanism behind the release kinetics. Terahertz pulsed imaging visualized that adhesion between the core and coat of the calendered tablet was not complete and a gradient in coat thickness (varying from 200 to 600 μm) was observed. Modulated differential scanning calorimetry and X-ray diffraction indicated that the solid-state properties of both drugs were not affected by the calendering procedure.     

Studies on the expression of the TNFα receptors (p55 and p75) and their relative contributions to prostanoid production and glycolytic rate by rheumatoid synovial fibroblasts in vitro

Summary The effect of monoclonal antibodies against the 55-and 75-kDa (p 55 and p 75) tumour necrosis factor (TNF) receptors on two tumour necrosis factor alpha (TNF ) induced responses was studied in rheumatoid synovial fibroblasts (RSF) in vitro. This provided functional evidence for the expression of both receptor types, which was confirmed by substantial inhibition of ¹²⁵ITNF binding to RSF by both antibodies. TNF stimulation of prostanoid production was found to be a function of ligand binding to both receptor types, wheras the stimulation of cellular glycolysis was largely mediated via the p55 receptor. Thus, we showed that RSF express both types of TNF receptor and functional studies showed that stimulation of each receptor results in both similar and dissimilar cellular responses.     

Nocturnal spikes of growth hormone secretion cause the dawn phenomenon in Type 1 (insulin-dependent) diabetes mellitus by decreasing hepatic (and extrahepatic) sensitivity to insulin in the absence of insulin waning

Summary The aim of the present studies was to test the hypothesis that the dawn phenomenon in Type 1 (insulin-de-pendent) diabetes mellitus is due to a decrease in insulin sensitivity caused by nocturnal spikes of growth hormone. Twelve subjects with Type 1 diabetes were studied on two different occasions, from 24.00 to 02.00 hours, and from 06.00 to 08.00 hours with the euglycaemic clamp technique at two plasma free insulin levels (25 mU/l,n=7; 80 mU/l,n=5). To eliminate the confounding factor of insulin waning of previous Biostator studies, prior to clamp experiments the diabetic subjects were infused with i.v. insulin by means of a syringe pump according to their minute-to-minute insulin requirements. Insulin sensitivity decreased at dawn as compared to the early night hours (30% increase in the rate of hepatic glucose production, 25% decrease in the rate of peripheral glucose utilisation). Plasma insulin clearance did not change overnight. In seven Type 1 diabetic subjects, suppression of nocturnal spikes of growth hormone secretion by somatostatin during basal glucagon and growth hormone replacement resulted in complete abolition of the increased rate of hepatic glucose production at dawn. Replacement of nocturnal spikes of growth hormone faithfully reproduced the increase in hepatic glucose production at dawn of the control study. It is concluded that the dawn phenomenon in Type 1 diabetes mellitus examined during optimal insulin replacement, first, is due solely to a decrease in insulin sensitivity and not to an increase in insulin clearance; second, that the decrease in insulin sensitivity at dawn takes place both in the liver and peripheral tissues; third, that the decrease in hepatic (and most likely extrahepatic) insulin sensitivity at dawn is caused by nocturnal spikes of growth hormone secretion.