AIMTo systematically review literature addressing three key psychologically-oriented controversies associated with gastroparesis.METHODSA comprehensive search of PubMed, CINAHL, and PsycINFO databases was performed to identify literature addressing the relationship between gastroparesis and psychological factors. Two researchers independently screened all references. Inclusion criteria were: an adult sample of gastroparesis patients, a quantitative methodology, and at least one of the following: (1) evaluation of the prevalence of psychopathology; (2) an outcome measure of anxiety, depression, or quality of life; and (3) evidence of a psychological intervention. Case studies, review articles, and publications in languages other than English were excluded from the current review.RESULTSPrevalence of psychopathology was evaluated by three studies (n = 378), which found that combined anxiety/depression was present in 24% of the gastroparesis cohort, severe anxiety in 12.4%, depression in 21.8%-23%, and somatization in 50%. Level of anxiety and depression was included as an outcome measure in six studies (n = 1408), and while limited research made it difficult to determine the level of anxiety and depression in the cohort, a clear positive relationship with gastroparesis symptom severity was evident. Quality of life was included as an outcome measure in 11 studies (n = 2076), with gastroparesis patients reporting lower quality of life than population norms, and a negative relationship between quality of life and symptom severity. One study assessed the use of a psychological intervention for gastroparesis patients (n = 120) and found that depression and gastric function were improved in patients who received psychological intervention, however the study had considerable methodological limitations.CONCLUSIONGastroparesis is associated with significant psychological distress and poor quality of life. Recommendations for future studies and the development of psychological interventions are provided.

The final model showed that the influence of gastroparesis symptom severity on psychological distress was fully mediated by illness perceptions, while the influence on QoL was partially mediated by illness perceptions. The study provides guidance for the development of psychological interventions targeted toward improving mediating psychological factors.

The findings of this study can help nurses and other healthcare professionals better understand the experience of living with gastroparesis and the factors that help patients best adapt to living with the condition. Nurses can help promote resilience in patients by discussing the importance of being health-focused rather than illness-focused. Nurses can also support patients by helping them problem-solve issues that may arise around social eating and remaining socially engaged.

<p>There has been a recent increase in demand for climate data and insights on the potential impacts of climate change. This is particularly true in the finance sector - in the past 18 months financial regulators in the UK, Europe, USA, Canada and elsewhere globally have all stipulated that large and listed firms are legally required to understand their climate risk and do something to mitigate that risk. The finance sector is not well placed to generate these climate risk insights, motivating the rise of multiple climate risk data providers.</p> <p>Climate X is a private-sector provider of climate risk analytics and services. Our in-house science team makes use of a wealth of publicly available data in the science that underpins the services we provide; data such as climate models and remote sensing data. We provide science as a service and deliver our data in a way that is useful and used within the finance sector.</p> <p>I will briefly outline how we use publicly available data to derive climate risk information that is relevant to the finance sector, and how we deliver that data in away that is meaningful to our end users. I will discuss why the data in its raw form doesn’t address sector requirements, and feedback from the sector on how publicly available climate and remote sensing data is used. I will summarise lessons learned from our engagement with finance on how the public sector could provide data which is tailored to end user needs, and is more immediately relevant and useful for adaptation action in this industry.</p>

<p>Increasingly the financial sector is interested in understanding their risk to the impacts of climate change. This is driven both by governmental regulation that requires financial services to declare their risks due to climate change, as well as a desire to mitigate risks to profits that climate change poses.</p> <p>To generate useful and accurate risks assessments users need access to high quality data of the projected changes to hazard due to climate change. However, there is typically a gap between scientific research and what our clients need to understand their risk. Many of the most damaging hazards, such as flooding and subsidence, are not directly modelled by climate models and require specialist hazard knowledge and well as climate data to assess. Scientific studies often focus on large scale changes or small regional studies, whereas clients need consistent high-resolution data across multiple regions. Additionally, a risk portfolio covers a wide range of climate related hazards, which all must be considered when understanding and attempting to mitigate risk. Users will often not have the inhouse knowledge to use data generated by the scientific community directly or the expertise to assess how this relates to the risks posed by different hazards. Therefore, the financial sector is turning to external data providers for this information, such as Climate X.</p> <p>This talk will cover how at Climate X we make reliable and robust risk assessments of climate hazards that are presented in a way that is usable and useful for the financial sector as well as various other decision makers. The focus will be on how we use open-source climate model data to generate our heat risk metric. This will cover the definition of the metric, how it is calculated and how we how we present the data to users including accuracy and uncertainty. I will also present overview of the other hazards that we provide and the need for an interdisciplinary team to cover the broad range of physical hazards related to climate change.</p>