Patients' recovery and non-recovery narratives after intravenous ketamine for treatment-resistant depression.

BACKGROUND: Intravenous (IV) ketamine is an effective therapy for treatment-resistant depression. A large data base is confirmatory and steadily expanding. Qualitative studies can inform best practices and suggest new research directions. As part of a clinical trial designed to identify biomarkers of ketamine response, a qualitative study was conducted to characterize experiences with: receiving infusions; recovering or not recovering from depression; and beliefs about why ketamine worked or did not work. METHODS: Adults with treatment-resistant depression received three IV ketamine infusions in a two-week period and were characterized as remitters or non-remitters via symptom reduction 24 h after the third infusion. Qualitative interviews of a subset of participants were audio recorded, transcribed verbatim, and coded using deductive and inductive methods. Themes were derived and compared across a broader construct of recovery status. RESULTS: Of the 21 participants, nine (43 %) were characterized as having experienced remission and 12 (57 %) non-remission. Of the 12 non-remitters, five were characterized as having experienced partial recovery based on their subjective experiences, reporting substantial benefit from ketamine infusions despite non-remission status based on scale measurements. Attributions for ketamine's effects included biological and experiential mechanisms. Among non-remitters there was risk of disappointment when adding another failed treatment. LIMITATIONS: A more diverse sample may have yielded different themes. Different patients had different amounts of time elapsed between ketamine infusions and qualitative interview. CONCLUSIONS: Qualitative methods may enhance researchers' characterization of IV ketamine's impact on treatment-resistant depression. While requiring confirmation, patients may benefit from a preparatory milieu that prepares them for multiple recovery pathways; decouples the psychedelic experience from clinical outcomes; and addresses potential risks of another failed treatment.

What factors are truly associated with risk for radicalisation? A secondary data analysis within a UK sample.

Radicalisation and extremist violence are of increasing concern internationally. The unconventional, decentralised, and transnational nature of modern terrorism involves an active process of radicalisation requiring national security responses to reflect findings from recent empirical research. This study aims to identify factors that relate to extremist attitudes and potential vulnerability to radicalisation in order to inform preventative action. A cross-sectional survey was conducted of a representative population sample of men and women aged 18-45 of Muslim heritage recruited by quota sampling in two English cities. Logistic regressions were performed on a seven-item dichotomised measure based on our previously developed scale of 'sympathy for terrorist acts'. Scores representing 'non-condemnation of these acts' were deemed to represent risk for radicalisation. Thirteen respondents had a positive score on the sympathy for terrorism measure (2.4%), 39 scored zero (6.41%) and the remainder (91.4%) had a negative score representing condemnation of terrorist acts. There was a significant association between sympathy for terrorism and belonging to the local or global Muslim community, anxiety, and support for the use of defensive violence. Gender, religious identity, country of birth, belief in Sharia law, the importance of religion in life, and mosque attendance were all not associated with sympathy for terrorism. The results contribute to an understanding of the radicalisation process and have potential value in developing preventative public health interventions.

Some Effects of Supplemental Pilates Training on the Posture, Strength, and Flexibility of Dancers 17 to 22 Years of Age.

Proper alignment in dancers is a pre-requisite for achieving aesthetic line and form and for efficient execution of movement. Pelvic alignment is a common deficit in dancers that results in faulty technique and impaired performance. Dancers must be able to obtain their personal neutral alignment to avoid injury and achieve ease of execution. This study was designed to examine the effects, qualitatively and quantitatively, of Pilates training on pelvic alignment, strength, and flexibility in dancers. Twenty female dancers, 17 to 22 years of age, participated in a screening that consisted of an AlignaBod posture screen, upper abdominal manual muscle test, double leg lower test, straight leg raise test, and modified Thomas test. Participants were screened, engaged in dance classes for 14 weeks without Pilates, and screened a second time. They then attended a 2-hour pelvic alignment workshop followed by two weekly Pilates classes, one mat and one apparatus, for 14 weeks. The study concluded with a final screening and collection of qualitative data regarding participant perceptions of their experience. Analysis demonstrated a decrease in the number of postural misalignments with Pilates intervention compared to no significant change in total misalignments when taking dance classes only. The prevalence of forward head posture, knee hyperextension, and foot-ankle pronation or supination all decreased significantly. After participating in the Pilates intervention, the prevalence of iliotibial band and hamstring inflexibility decreased and lower abdominal muscle strength improved significantly. All participants reported they felt that Pilates improved their core stability, pelvic alignment, strength, and body awareness. This study suggests that Pilates, when added to dance training, can improve postural alignment, flexibility, and abdominal strength in dancers. Additionally, it is well tolerated by dancers, making it a potentially valuable cross-training tool.