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Americans are not invulnerable to factual information. They do not 'backfire'; facts do not make them less accurate. Instead, they become more accurate, even when corrections target co-partisans. Corrections of fake news yield similar results. Among Republicans, Trump's misstatements are less susceptible to corrections than identical misstatements attributed to other Republicans. While we do not observe facts affecting attitudes, multiple instances of misinformation can increase approval of the responsible politician - but corrections can reduce approval by similar amounts. While corrections do not eliminate false beliefs, they reduce the share of inaccurate beliefs among subjects in this study nearly in half.
Despite knowing for many decades that depressive psychopathology is common in first-episode schizophrenia spectrum disorders (FES), there is limited knowledge regarding the extent and nature of such psychopathology (degree of comorbidity, caseness, severity) and its demographic, clinical, functional and treatment correlates. This study aimed to determine the pooled prevalence of depressive disorder and caseness, and the pooled mean severity of depressive symptoms, as well as the demographic, illness, functional and treatment correlates of depressive psychopathology in FES.
This systematic review, meta-analysis and meta-regression was prospectively registered (CRD42018084856) and conducted in accordance with PRISMA and MOOSE guidelines.
Forty studies comprising 4041 participants were included. The pooled prevalence of depressive disorder and caseness was 26.0% (seven samples, N = 855, 95% CI 22.1–30.3) and 43.9% (11 samples, N = 1312, 95% CI 30.3–58.4), respectively. The pooled mean percentage of maximum depressive symptom severity was 25.1 (38 samples, N = 3180, 95% CI 21.49–28.68). Correlates of depressive psychopathology were also found.
At least one-quarter of individuals with FES will experience, and therefore require treatment for, a full-threshold depressive disorder. Nearly half will experience levels of depressive symptoms that are severe enough to warrant diagnostic investigation and therefore clinical intervention – regardless of whether they actually fulfil diagnostic criteria for a depressive disorder. Depressive psychopathology is prominent in FES, manifesting not only as superimposed comorbidity, but also as an inextricable symptom domain.
Timely access to care services is crucial to support people with dementia and their family carers to live well. Carers of people with dementia (N = 390), recruited from eight countries, completed semi-structured interviews about their experiences of either accessing or not using formal care services over a 12-month period in the Access to Timely Formal Care (Actifcare) study. Participant responses were summarised using content analysis, categorised into clusters and frequencies were calculated. Less than half of the participants (42.3%) reported service use. Of those using services, 72.8 per cent reported timely access and of those not using services 67.2 per cent were satisfied with this situation. However, substantial minorities either reported access at the wrong time (27.2%), or feeling dissatisfied or mixed feelings about not accessing services (32.8%). Reasons for not using services included use not necessary yet, the carer provided support or refusal. Reasons given for using services included changes in the condition of the person with dementia, the service's ability to meet individual needs, not coping or the opportunity to access services arose. Facilitators and barriers to service use included whether participants experienced supportive professionals, the speed of the process, whether the general practitioner was helpful, participant's own proactive attitude and the quality of information received. To achieve timely support, simplified pathways to use of formal care services are needed.
Dorothea Weltecke has remarked that we should not think of ecclesiastical history as a tree that grows from a single root in the Acts of the Apostles and Eusebius. As she argues, we may be better off thinking of churches as networks of individuals or as a bamboo forest, of distinct institutions planted in the same soil.1 However, as a historiography, ecclesiastical history does present itself as a single tree, to follow Weltecke’s analogy, some of whose branches withered away as they abandoned ‘orthodoxy’. Our challenge, therefore, is to write a history of the historians as image makers, emphasising their continuity with the past, while acknowledging that the raw material from which they constructed this image, often the events of their own times, forced innovation, some of it conscious and some of it unconscious.
Although behavior therapy reduces tic severity, it is unknown whether it improves co-occurring psychiatric symptoms and functional outcomes for adults with Tourette's disorder (TD). This information is essential for effective treatment planning. This study examined the effects of behavior therapy on psychiatric symptoms and functional outcomes in older adolescents and adults with TD.
A total of 122 individuals with TD or a chronic tic disorder participated in a clinical trial comparing behavior therapy to psychoeducation and supportive therapy. At baseline, posttreatment, and follow-up visits, participants completed assessments of tic severity, co-occurring symptoms (inattention, impulsiveness, hyperactivity, anger, anxiety, depression, obsessions, and compulsions), and psychosocial functioning. We compared changes in tic severity, psychiatric symptoms, and functional outcomes using repeated measure and one-way analysis of variance.
At posttreatment, participants receiving behavior therapy reported greater reductions in obsessions compared to participants in supportive therapy (
$\eta _p^2 $
= 0.04, p = 0.04). Across treatments, a positive treatment response on the Clinical Global Impression of Improvement scale was associated with a reduced disruption in family life (
$\eta _p^2 $
= 0.05, p = 0.02) and improved functioning in a parental role (
$\eta _p^2 $
= 0.37, p = 0.02). Participants who responded positively to eight sessions of behavior therapy had an improvement in tic severity (
$\eta _p^2 $
= 0.75, p < 0.001), inattention (
$\eta _p^2 $
= 0.48, p < 0.02), and functioning (
$\eta _p^2 $
= 0.39–0.42, p < 0.03–0.04) at the 6-month follow-up.
Behavior therapy has a therapeutic benefit for co-occurring obsessive symptoms in the short-term, and reduces tic severity and disability in adults with TD over time. Additional treatments may be necessary to address co-occurring symptoms and improve functional outcomes.
The study provides a comprehensive insight into how an initial receiving hospital without adequate capacity adapted to coping with a mass casualty incident after the Formosa Fun Coast Dust Explosion (FFCDE).
Data collection was via in-depth interviews with 11 key participants. This was combined with information from medical records of FFCDE patients and admission logs from the emergency department (ED) to build a detailed timeline of patients flow and ED workload changes. Process tracing analysis focused on how the ED and other units adapted to coping with the difficulties created by the patient surge.
The hospital treated 30 victims with 36.3% average total body surface area burn for over 5 hours alongside 35 non-FFCDE patients. Overwhelming demand resulted in the saturation of ED space and intensive care unit beds, exhaustion of critical materials, and near-saturation of clinicians. The hospital reconfigured human and physical resources differently from conventional drills. Graphical timelines illustrate anticipatory or reactive adaptations. The hospital’s ability to adapt was based on anticipation during uncertainty and coordination across roles and units to keep pace with varying demands.
Adapting to beyond-surge capacity incident is essential to effective disaster response. Building organizational support for effective adaptation is critical for disaster planning.
From the 1330s, alabaster was a material of status used to commemorate the elite of England. It was used initially for royal tombs (Edward II, John of Eltham, William of Hatfield, the dowager Queen Isabella and Philippa of Hainaut), bishops (John Stratford, William Eddington, Ralph of Shrewsbury, Thomas Hatfield and others) and the nobility. During the second half of the fourteenth century it became the conventional material for knights’ tombs and was occasionally also used for members of the legal profession. By and large, the merchant classes seem to have been excluded from this elite form of commemoration. Very few had effigial tombs, whether of alabaster or other any material, though some, like the merchants of Northleach, had floor brasses. A tiny group of alabaster merchants’ tombs also survives, virtually unstudied to date, so the aim here is to redress this omission. Why only those few select merchants were commemorated in alabaster is a question difficult to answer, as we shall see.
In the late medieval period social status and wealth did not necessarily go together. The average English merchant was significantly wealthier than the average knight and sometimes the nobility, but a stigma was attached to that wealth. According to the chivalric code, it was acceptable to make money through warfare, advantageous marriage or activities at court but not through commerce. Merchants and their families were in theory tainted by virtue of their activity. How much this actually mattered in practice to dowry-seeking social superiors is debatable, and not all merchants necessarily hungered after gentle status. They did behave increasingly like their social superiors, however, building stone houses, endowing religious institutions and, if sumptuary laws can be taken to arise out of actual behaviours that needed to be curbed, dressing grandly. The sumptuary laws of 1363 required merchants to have goods worth L500 in order to claim the privileges of squires and gentlemen worth only L100. The desire for distinctive commemoration after death would seem on the face of it to be consistent with the alleged social ambitions of the merchant class. Yet only a small number of merchants were commemorated in alabaster like the landed classes.
Intracranial aneurysm (IA) is an expansion of the weakened arterial wall that is often asymptomatic until rupture, resulting in subarachnoid hemorrhage. Here we describe the high prevalence of familial IA in a cohort of Newfoundland ancestry. We began to investigate the genetic etiology of IA in affected family members, as the inheritance of this disease is poorly understood.
Whole exome sequencing was completed for a cohort of 12 affected individuals from two multiplex families with a strong family history of IA. A filtering strategy was implemented to identify rare, shared variants. Filtered variants were prioritized based on validation by Sanger sequencing and segregation within the families.
In family R1352, six variants passed filtering; while in family R1256, 68 variants remained, so further filtering was pursued. Following validation by Sanger sequencing, top candidates were investigated in a set of population controls, namely, C4orf6 c.A1G (p.M1V) and SPDYE4c.C103T (p.P35S). Neither was detected in 100 Newfoundland control samples.
Rare and potentially deleterious variants were identified in both families, though incomplete segregation was identified for all filtered variants. Alternate methods of variant prioritization and broader considerations regarding the interplay of genetic and environmental factors are necessary in future studies of this disease.
In recent years, the discovery of massive quasars at
has provided a striking challenge to our understanding of the origin and growth of supermassive black holes in the early Universe. Mounting observational and theoretical evidence indicates the viability of massive seeds, formed by the collapse of supermassive stars, as a progenitor model for such early, massive accreting black holes. Although considerable progress has been made in our theoretical understanding, many questions remain regarding how (and how often) such objects may form, how they live and die, and how next generation observatories may yield new insight into the origin of these primordial titans. This review focusses on our present understanding of this remarkable formation scenario, based on the discussions held at the Monash Prato Centre from November 20 to 24, 2017, during the workshop ‘Titans of the Early Universe: The Origin of the First Supermassive Black Holes’.
The Bubog-1 rockshelter on Ilin Island has provided important evidence for Late Pleistocene to Mid-Holocene (c. 33 000–4000 cal BP) human habitation, yet little is known about the contemporaneous transmission of material culture, technology and mortuary practices across Island Southeast Asia. Recent archaeological research at Bubog-1 has revealed a tightly flexed inhumation dating to c. 5000 cal BP—a type representative of a widespread, contemporaneous burial practice observed across the region. The emergence of diverse burial practices and their spread across Island Southeast Asia coincides with evidence for technological innovation and increasing long-distance interaction between island communities.
We aimed to provide comprehensive estimates of laboratory-confirmed respiratory syncytial virus (RSV)-associated hospitalisations. Between 2012 and 2015, active surveillance of acute respiratory infection (ARI) hospitalisations during winter seasons was used to estimate the seasonal incidence of laboratory-confirmed RSV hospitalisations in children aged <5 years in Auckland, New Zealand (NZ). Incidence rates were estimated by fine age group, ethnicity and socio-economic status (SES) strata. Additionally, RSV disease estimates determined through active surveillance were compared to rates estimated from hospital discharge codes. There were 5309 ARI hospitalisations among children during the study period, of which 3923 (73.9%) were tested for RSV and 1597 (40.7%) were RSV-positive. The seasonal incidence of RSV-associated ARI hospitalisations, once corrected for non-testing, was 6.1 (95% confidence intervals 5.8–6.4) per 1000 children <5 years old. The highest incidence was among children aged <3 months. Being of indigenous Māori or Pacific ethnicity or living in a neighbourhood with low SES independently increased the risk of an RSV-associated hospitalisation. RSV hospital discharge codes had a sensitivity of 71% for identifying laboratory-confirmed RSV cases. RSV infection is a leading cause of hospitalisation among children in NZ, with significant disparities by ethnicity and SES. Our findings highlight the need for effective RSV vaccines and therapies.
The overarching cultural context of the brain injury survivor, particularly that related to minority peoples with a history of colonisation and discrimination, has rarely been referred to in the research literature, despite profoundly influencing a person’s recovery journey in significant ways, including access to services. This study highlights issues faced by Australian Aboriginal traumatic brain injury (TBI) survivors in terms of real-life consequences of the high incidence of TBI in this population, current treatment and long-term challenges.
A case study approach utilised qualitative interview and file review data related to five male Aboriginal TBI survivors diagnosed with acquired communication disorders. The five TBI survivors were from diverse areas of rural and remote Western Australia, aged between 19 and 48 years at the time of injury, with a range of severity.
Common themes included: significant long-term life changes; short-term and long-term dislocation from family and country as medical intervention and rehabilitation were undertaken away from the person’s rural/remote home; family adjustments to the TBI including permanent re-location to a metropolitan area to be with their family member in residential care; challenges related to lack of formal rehabilitation services in rural areas; poor communication channels; poor cultural security of services; and lack of consistent follow-up.
Discussion and Conclusion:
These case reports represent some of the first documented stories of Aboriginal Australian TBI survivors. They supplement available epidemiological data and highlight different contexts for Aboriginal people after TBI, contributing to an overall profile that is relevant for rehabilitation service planning.
The overarching goal of this work is to support creative ideation in engineering design with the aim of overcoming design fixation. We study the impact of abstract representations and ways to frame the problem in design briefs on the creativity of concept sketches. Framing/Reframing involves shifting perspectives on the design purpose and to reveal insights and opportunities. Two Framing/Reframing techniques are tested: the Ishikawa/Fishbone Diagram to identify root causes and a blend of Parnes’ Restatement/SCAMPER method to encourage divergence in problem perception. Abstract representations of requirements were used as stimuli to foster transfer and associative thinking. Using a full-factorial experimental design with brief variations, C-Sketch ideas developed by first-year engineering/architecture students were evaluated for their creativity. Our results showed a positive interaction effect for novelty and usefulness when the Fishbone Reframing method was used with abstract representation, but there was no difference in creativity scores when comparing the two Framing/Reframing methods between each other.
While prototypes are critical to the creation of successful products and innovative solutions, building a prototype is characterized by large sunk costs and a plethora of unknowns. The versatility and effectiveness of prototypes paired with the ambiguous nature of developing a prototype can lead to wasted resources. Recent studies support this claim, demonstrating that under certain circumstances, designers often prototype without a clear purpose, building prototypes as a function of the design process rather than as a function of the design. These findings motivated the creation of the Prototyping Canvas, a tool to aid designers in planning for purposeful prototypes by identifying critical assumptions and questions to guide development. Business and engineering design literature influenced the development of the canvas, which was first tested with a client project in the SUTD-MIT International Design Centre (IDC). The feedback and insights from the design team guided revisions to the canvas. The updated canvas was then validated with 55 professionals during a design project sprint. The purpose of this paper is to present the Prototyping Canvas as a valid and effective design tool.