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The question presented for our review is alleged to be complicated one, but it is instead rather easily stated and ruled upon. May Dominick (the Appellant), serving as trustee of a spendthrift trust that his mother Inez (the Settlor) created for the benefit of his brother John (the Trust Beneficiary) refuse to distribute trust funds to satisfy John’s current and past child support obligations, even if John wishes to make the payments? We would like to take a moment to rephrase this issue a bit less formally, stating instead: May a man, who has been put in charge of managing funds for another man, arbitrarily decide to deprive a mother and two children of the court-ordered funds they are entitled to receive for basic survival and necessities?17 Despite the Appellant’s unpersuasive arguments to the contrary and misplaced reliance on irrelevant case law, we think this question is not as complicated as it is alleged to be, and we thus answer this question unabashedly in the negative.
The inclusion of students with autism spectrum disorder (ASD) is increasing, but there have been no longitudinal studies of included students in Australia. Interview data reported in this study concern primary school children with ASD enrolled in mainstream classes in South Australia and New South Wales, Australia. In order to examine perceived facilitators and barriers to inclusion, parents, teachers, and principals were asked to comment on the facilitators and barriers to inclusion relevant to each child. Data are reported about 60 students, comprising a total of 305 parent interviews, 208 teacher interviews, and 227 principal interviews collected at 6-monthly intervals over 3.5 years. The most commonly mentioned facilitator was teacher practices. The most commonly mentioned barrier was intrinsic student factors. Other factors not directly controllable by school staff, such as resource limitations, were also commonly identified by principals and teachers. Parents were more likely to mention school- or teacher-related barriers. Many of the current findings were consistent with previous studies but some differences were noted, including limited reporting of sensory issues and bullying as barriers. There was little change in the pattern of facilitators and barriers identified by respondents over time. A number of implications for practice and directions for future research are discussed.
A field study was conducted in 2017 and 2018 to determine foliar efficacy of halauxifen-methyl, 2,4-D, or dicamba applied alone and in combination with glyphosate at preplant burndown timing. Experiments were conducted near Painter, VA, Rocky Mount, NC, Jackson, NC, and Gates, NC. Control of horseweed, henbit, purple deadnettle, cutleaf evening primrose, curly dock, purple cudweed, and common chickweed were evaluated. Halauxifen-methyl applied at 5 g ae ha-1 controlled small and large horseweed 89% and 79%, respectively, and was similar to control by dicamba applied at 280 g ae ha-1. Both rates of 2,4-D at 533 (Low Rate, LR) or 1066 (High Rate, HR) g ae ha-1 were less effective than halauxifen-methyl and dicamba for controlling horseweed. Halauxifen-methyl was the only auxin herbicide to control henbit (90%) and purple deadnettle (99%). Cutleaf eveningprimrose was controlled 74 to 85%, 51%, and 4% by 2,4-D, dicamba, and halauxifen-methyl, respectively. Dicamba and 2,4-D controlled curly dock 59 to 70% and were more effective than halauxifen-methyl (5%). Auxin herbicides applied alone controlled purple cudweed and common chickweed ≤ 21%. With the exception of cutleaf evening primrose (35%) and curly dock (37%), glyphosate alone provided ≥ 95% control of all weeds evaluated. These experiments demonstrate halauxifen-methyl effectively (≥ 79%) controls horseweed, henbit, and purple deadnettle, whereas common chickweed, curly dock, cutleaf evening-primrose, and purple cudweed control by the herbicide is inadequate (≤ 7%).
Schizophrenia is a disorder characterized by pervasive deficits in cognitive functioning. However, few well-powered studies have examined the degree to which cognitive performance is impaired even among individuals with schizophrenia not currently on antipsychotic medications using a wide range of cognitive and reinforcement learning measures derived from cognitive neuroscience. Such research is particularly needed in the domain of reinforcement learning, given the central role of dopamine in reinforcement learning, and the potential impact of antipsychotic medications on dopamine function.
The present study sought to fill this gap by examining healthy controls (N = 75), unmedicated (N = 48) and medicated (N = 148) individuals with schizophrenia. Participants were recruited across five sites as part of the CNTRaCS Consortium to complete tasks assessing processing speed, cognitive control, working memory, verbal learning, relational encoding and retrieval, visual integration and reinforcement learning.
Individuals with schizophrenia who were not taking antipsychotic medications, as well as those taking antipsychotic medications, showed pervasive deficits across cognitive domains including reinforcement learning, processing speed, cognitive control, working memory, verbal learning and relational encoding and retrieval. Further, we found that chlorpromazine equivalency rates were significantly related to processing speed and working memory, while there were no significant relationships between anticholinergic load and performance on other tasks.
These findings add to a body of literature suggesting that cognitive deficits are an enduring aspect of schizophrenia, present in those off antipsychotic medications as well as those taking antipsychotic medications.
This study aims to clarify the association between prosperity and the coronavirus disease (COVID-19) outcomes and its impact on the future management of pandemics.
This is an observational study using information from 2 online registries. The numbers of infected individuals and deaths and the prosperity rank of each country were obtained from worldometer.info and the Legatum Institute’s Prosperity Index, respectively.
There is a combination of countries with high and low prosperity on the list of COVID-19-infected countries. The risk of the virus pandemic seems to be more extensive in countries with high prosperity. A Spearman’s rho test confirmed a significant correlation between prosperity, the number of COVID-19 cases, and the number of deaths at the 99% level.
New emerging pandemics affect all nations. In order to increase the likelihood of successfully managing future events, it is important to consider preexisting health security, valid population-based management approaches, medical decision-making, communication, continuous assessment, triage, treatment, early and complete physical distancing strategies, and logistics. These elements cannot be taught on-site and on occasion. There is a need for innovative and regular educational activities for all stakeholders committed to safeguarding our future defense systems concerning diagnostic, protection, treatment, and rehabilitation in pandemics, as well as other emergencies.
Worldwide, governments employ health technology assessment (HTA) in healthcare funding decision making. Requests to include public perspectives in this are increasing, with the idea being that the public can identify social values to guide policy development, increasing the transparency and accountability of government decision making.
To understand the perspectives of the Canadian public on the rationale and design of public involvement in HTA.
A demographically representative sample of residents of a Canadian province was selected to take part in two sets of two focus groups (sixteen people for the first set and twenty for the second set).
Participants were suspicious of the interests driving various stakeholders involved in HTA. They saw the public as uniquely impartial though also lacking knowledge about health technologies. Participants were also suspicious of personal biases and commended mechanisms to reduce their impact. Participants suggested various involvement methods, such as focus groups, citizens' juries and surveys, noting advantages and disadvantages belonging to each and commending a combination.
Discussion and conclusions
We identified a lack of public understanding of how decisions are made and distrust concerning whose interests and values are being considered. Public involvement was seen as a way of providing information to the public and ascertaining their views and values. Participants suggested that public involvement should employ a mixed-methods strategy to support informed debate and participation of a large number of people.
The prevalence of mental health conditions and national suicide rates are increasing in many countries. Lithium is widely and effectively used in pharmacological doses for the treatment and prevention of manic/depressive episodes, stabilising mood and reducing the risk of suicide. Since the 1990s, several ecological studies have tested the hypothesis that trace doses of naturally occurring lithium in drinking water may have a protective effect against suicide in the general population.
To synthesise the global evidence on the association between lithium levels in drinking water and suicide mortality rates.
The MEDLINE, Embase, Web of Science and PsycINFO databases were searched to identify eligible ecological studies published between 1 January 1946 and 10 September 2018. Standardised regression coefficients for total (i.e. both genders combined), male and female suicide mortality rates were extracted and pooled using random-effects meta-analysis. The study was registered with PROSPERO (CRD42016041375).
The literature search identified 415 articles; of these, 15 ecological studies were included in the synthesis. The random-effects meta-analysis showed a consistent protective (or inverse) association between lithium levels/concentration in publicly available drinking water and total (pooled β = −0.27, 95% CI −0.47 to −0.08; P = 0.006, I2 = 83.3%), male (pooled β = −0.26, 95% CI −0.56 to 0.03; P = 0.08, I2 = 91.9%) and female (pooled β = −0.13, 95% CI −0.24 to −0.02; P = 0.03, I2 = 28.5%) suicide mortality rates. A similar protective association was observed in the six studies included in the narrative synthesis, and subgroup meta-analyses based on the higher/lower suicide mortality rates and lithium levels/concentration.
This synthesis of ecological studies, which are subject to the ecological fallacy/bias, supports the hypothesis that there is a protective (or inverse) association between lithium intakes from public drinking water and suicide mortality at the population level. Naturally occurring lithium in drinking water may have the potential to reduce the risk of suicide and may possibly help in mood stabilisation, particularly in populations with relatively high suicide rates and geographical areas with a greater range of lithium concentration in the drinking water. All the available evidence suggests that randomised community trials of lithium supplementation of the water supply might be a means of testing the hypothesis, particularly in communities (or settings) with demonstrated high prevalence of mental health conditions, violent criminal behaviour, chronic substance misuse and risk of suicide.
Groups are increasingly used to deliver behavior change interventions, but such interventions are seldom based on theory and research on social group processes. A consequence of this is that existing group interventions are often heterogenous and difficult to evaluate. The social identity approach addresses important questions relevant to the design and delivery of group interventions for supporting behavior change. Drawing on this approach, the social identity model of behavior change explains how group processes can be harnessed in behavior change interventions. The model prioritizes the establishment of shared social identity among intervention group members and outlines how, through six core group resources, social identification can shape delivery of intervention content to achieve behavior change. Evidence for the key resources specified in the model is presented, and a step-by-step guide provided, to support the operationalization of the model’s principles in practice.
Political leaders’ willingness to use force is central to many explanations of foreign policy and interstate conflict. Unfortunately, existing indicators typically measure one aspect of this general concept, have limited coverage, and/or are not derived independently of leaders’ participation in interstate conflicts. We develop a strategy for constructing measures of leaders’ underlying willingness to use force with data on their background experiences, political orientations, and psychological traits in a Bayesian latent variable framework. Our approach produces measures of latent hawkishness for all national leaders between 1875 and 2004 that offer advantages over existing proxies along multiple dimensions, including construct validity, predictive validity, and measurement uncertainty. Importantly, our statistical framework allows scholars to build upon our measures by incorporating additional data and altering the assumptions underlying our models.
Fibrinolysis is an acceptable treatment for acute ST-segment elevation myocardial infarction (STEMI) when primary percutaneous coronary intervention (PCI) cannot be performed within 120 minutes. The American Heart Association has recommended Emergency Medical Services (EMS) interventions such as prehospital fibrinolysis (PHF), prehospital electrocardiogram (ECG), and hospital bypass direct to PCI center. Nova Scotia, Canada has incorporated these interventions into a unique province-wide approach to STEMI care. A retrospective cohort analysis comparing the primary outcome of 30-day mortality for patients receiving either prehospital or emergency department (ED) fibrinolysis (EDF) to patients transported directly by EMS from community or regional ED for primary PCI was conducted.
This retrospective, population-based cohort study included all STEMI patients in Nova Scotia who survived to hospital admission from July 2011 through July 2013. Three provincial databases were used to collect demographic, 30-day mortality, hospital readmission, and rescue PCI data. The results were grouped and compared according to reperfusion strategy received: PHF, EDF, patients brought by ambulance via EMS direct to PCI (EMS to PCI), and ED to PCI (ED to PCI).
There were 1,071 STEMI patients included with 145 PHF, 606 EDF, 98 EMS to PCI, and 222 ED to PCI. There were no significant differences in 30-day mortality across groups (n, %): PHF 5(3); EDF 36(6); EHS to PCI <5(2); and ED to PCI 10(4); P = .28. There was no significant difference in patients receiving fibrinolysis who underwent rescue PCI.
Prehospital fibrinolysis incorporated into a province-wide approach to STEMI treatment is feasible with no observed difference in patient 30-day mortality outcomes observed.