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The last chapter of this volume is somewhat unusual for an edited book in social science research on peace and transitional justice. But, it is one that we thought it was important to include. “Geographies of Truth,” by personnel from the Casa de la Memoria (House of Memory) of Medellin, is a discussion of how individuals from the museum developed key exhibits on the violence in Colombia. This process begins with a great many similarities to social science projects as literature is reviewed, original data are collected, and all the materials are analyzed for their relevance and role in, in this case, museum exhibits. At this stage, scholars would typically then conceive of our understanding and representation of events of the past in fairly conventional, analytical products that are designed to communicate to fellow academics. But those who curate museums like Casa de la Memoria must arrive at a work product in ways that will affect people not just intellectually but also emotionally and physically through the various senses. Such exhibits are also constructed for a much larger audience − the people of the nation − whose experiences are being represented. Thus, the process by which these exhibits are created is both fascinating as both an alternative means of conveying understandings about war and violence, and for the responsibilities the museum personnel have toward society as a whole in representing their truths. There is much we, as peace studies scholars, can gain from understanding their work.
Background: Lumbar puncture (LP) is a low-risk procedure performed on pediatric patients for a variety of indications. There are no published studies of the nature of the concerns of parents in North America, and no studies examining a process to improve pediatric lumbar puncture consent. Methods: 72 patient-parent dyads were enrolled in a randomized control trial to receive standard consent with or without an educational video. A survey was provided to determine parent self-rated understanding of the procedure, their perception of its safety, their perception of the painfulness and their overall comfort with their child undergoing LP. In addition, demographic characteristics and qualitative information about parent concerns were collected. Results: Viewing the video significantly increased parent understanding of the procedure (p=0.015) and their perception of its safety (p=0.021) compared to controls. Parent comfort with the procedure increased after viewing the video (p = 0.002). Variability of answers was reduced in the video group (p = 0.03). Parents’ top three concerns were pain, infection, and neurologic injury. Conclusions: Pediatric lumbar puncture consent can be significantly improved with a short educational video to address the parental concerns and standardize consent.
It has long been argued that mood fluctuation patterns in Antarctic expeditioners are largely homogeneous. This research investigated mood fluctuation patterns throughout all the stages of Antarctic deployment using latent class growth analysis. Utilising advanced statistical methods, such as latent class growth analysis, can greatly help in identifying if mood fluctuation patterns experienced by Antarctic expeditioners are homogenous, and provide insight into mood fluctuation patterns, which was not possible with traditional group-based quantitative methods. Gaining a greater insight into mood fluctuation patterns in Antarctic expeditioners can assist with the development, and implementation of, strategies to assist with expeditioner well-being. The analysis was conducted on 423 expeditioner from the Australian Antarctic program between the 2005-2009 Antarctic deployment seasons. The results supported the notion that mood fluctuation patterns in expeditioners within the Australian-Antarctic programme were largely homogeneous, as a 1-class cubic latent class growth model was identified as being the optimal fit for the dataset. Theoretical and practical implications are discussed in relation to research and prevention and intervention strategies.
The relationship between alcohol consumption and body weight is complex and inconclusive being potentially mediated by alcohol type, habitual consumption levels and sex differences. Heavy and regular alcohol consumption has been positively correlated with increasing body weight, although it is unclear whether this is due to alcohol consumption per se or to additional energy intake from food. This review explores the effects of alcohol consumption on food energy intake in healthy adults. CINAHL Plus, EMBASE, Medline and PsycINFO were searched through February 2018 for crossover and randomised controlled trials where an alcohol dose was compared with a non-alcohol condition. Study quality was assessed using the Effective Public Health Practice Project tool. A total of twenty-two studies involving 701 participants were included from the 18 427 papers retrieved. Studies consistently demonstrated no compensation for alcoholic beverage energy intake, with dietary energy intake not decreasing due to alcoholic beverage ingestion. Meta-analyses using the random-effects model were conducted on twelve studies and demonstrated that alcoholic beverage consumption significantly increased food energy intake and total energy intake compared with a non-alcoholic comparator by weighted mean differences of 343 (95 % CI 161, 525) and 1072 (95 % CI 820, 1323) kJ, respectively. Generalisability is limited to younger adults (18–37 years), and meta-analyses for some outcomes had substantial statistical heterogeneity or evidence of small-study effects. This review suggests that adults do not compensate appropriately for alcohol energy by eating less, and a relatively modest alcohol dose may lead to an increase in food consumption.
Machine learning methods are being increasingly applied to physical healthcare. In this article we describe some of the potential benefits, challenges and limitations of this approach in a mental health context. We provide a number of examples where machine learning could add value beyond conventional statistical modelling.
Out-of-area (OOA) placements occur when patients cannot be admitted to local facilities, which can be extremely stressful for patients and families. Thus, the Department of Health aims to eliminate the need for OOA admissions. Using data from a UK mental health trust we developed a ‘virtual mental health ward’ to evaluate the potential impact of referral rates and length of stay (LOS) on OOA rates. The results indicated OOA rates were equally sensitive to LOS and referral rate. This suggests that investment in community services that reduce both LOS and referral rates are required to meaningfully reduce OOA admission rates.
Declaration of interest
P.A.T. holds an honorary consultant contract with the Tees, Esk and Wear Valleys NHS Foundation Trust.
Dietary fatty acid (FA) composition may influence metabolism, possibly affecting weight management. The purpose of this study was to compare the effects of a 5-d diet rich in PUFA v. MUFA. A total of fifteen normal-weight men participated in a randomised cross-over design with two feeding trials (3 d lead-in diet, pre-diet visit, 5-d PUFA- or MUFA-rich diet, post-diet visit). The 5-d diets (50 % fat) were rich in either PUFA (25 % of energy) or MUFA (25 % of energy). At pre- and post-diet visits, subjects consumed breakfast and lunch test meals, rich in the FA for that 5-d diet. Indirect calorimetry was used for 4 h after each meal. There were no treatment differences in fasting metabolism acutely or after the 5-d diet. For acute meal responses before diet, RER was higher for PUFA v. MUFA (0·86 (sem 0·01) v. 0·84 (sem 0·01), P<0·05), whereas diet-induced thermogenesis (DIT) was lower for PUFA v. MUFA (18·91 (SEM 1·46) v. 21·46 (SEM 1·34) kJ, P<0·05). After the 5-d diets, the change in RER was different for PUFA v. MUFA (−0·02 (sem 0·01) v. 0·00 (sem 0·01), P<0·05). Similarly, the change in fat oxidation was greater for PUFA v. MUFA (0·18 (sem 0·07) v. 0·04 (sem 0·06) g, P<0·05). In conclusion, acutely, a MUFA-rich meal results in lower RER and greater DIT. However, after a 5-d high-fat diet, the change in metabolic responses was greater in the PUFA diet, showing the metabolic adaptability of a PUFA-rich diet.
Release methods can influence the outcome of reintroductions. We tested the effect of delayed, immediate and supplementary food/shelter release treatments on the reintroduction of brushtail possums Trichosurus vulpecula to an environment in which introduced predators, particularly foxes, were subject to control. Monitoring of 48 radio-collared possums over 3 months revealed that immediate release possums settled into a stable range significantly faster than other groups, but there were no differences in survival, dispersal distance, reproduction or body condition. Ten days after release possums from all treatment groups had lost body mass, but by day 60 most were heavier than at the time of translocation. After release, possums sometimes used shelter sites easily accessible to predators, but within 3 weeks they regularly selected safer shelter. Risky shelter selection and loss of condition immediately after release suggests that supplementary food and shelter could be beneficial, but supportive measures were rarely used or did not have the desired effect. In an environment with higher predator densities, risky shelter selection could lead to high post-release predation, and mass loss could encourage animals to forage in riskier ways, further increasing vulnerability. In these environments effective uptake of supplementary food and shelter could reduce predation risk, but supplementary measures would need to be presented in a way that maximises uptake. In contrast, if post-release predation risk is low then supportive measures may not be required. Innovative methods for providing post-release support should continue to be developed for reintroductions to areas where supportive measures are needed.
Capturing service users’ perspectives can highlight additional and different concerns to those of clinicians, but there are no up to date, self-report psychometrically sound measures of side effects of antipsychotic medications.
To develop a psychometrically sound measure to identify antipsychotic side effects important to service users, the Maudsley Side Effects (MSE) measure.
An initial item bank was subjected to a Delphi exercise (n = 9) with psychiatrists and pharmacists, followed by service user focus groups and expert panels (n = 15) to determine item relevance and language. Feasibility and comprehensive psychometric properties were established in two samples (N43 and N50). We investigated whether we could predict the three most important side effects for individuals from their frequency, severity and life impact.
MSE is a 53-item measure with good reliability and validity. Poorer mental and physical health, but not psychotic symptoms, was related to side-effect burden. Seventy-nine percent of items were chosen as one of the three most important effects. Severity, impact and distress only predicted ‘putting on weight’ which was more distressing, more severe and had more life impact in those for whom it was most important.
MSE is a self-report questionnaire that identifies reliably the side-effect burden as experienced by patients. Identifying key side effects important to patients can act as a starting point for joint decision making on the type and the dose of medication.
Dietary fatty acid composition likely affects prediabetic conditions such as isolated impaired fasting glucose (IFG) or impaired glucose tolerance (IGT); however, this risk has not been evaluated in a large population nor has it been followed prospectively.
Diet, physical activity, anthropometric, socio-economic and blood glucose data from the Atherosclerosis Risk in Communities (ARIC) study were obtained from BioLINCC. Cox proportional hazards regression models were used to evaluate associations of dietary SFA, MUFA, PUFA, n-3 fatty acid (FA) and n-6 FA intakes with incidence of one (isolated IFG) or two (IFG with IGT) prediabetic conditions at the end of 12-year follow-up.
Study volunteers were from counties in North Carolina, Mississippi, Minnesota and Maryland, USA.
Data from 5288 volunteers who participated in the ARIC study were used for all analyses reported herein.
The study population was 62% male and 84 % white, mean age 53·5 (sd 5·7) years and mean BMI 26·2 (sd 4·6) kg/m2. A moderately high intake of dietary MUFA (10–15 % of total daily energy) was associated with a 10 % reduced risk of isolated IFG incidence, while a high intake of n-3 FA (>0·15 % of total daily energy) was associated with a 10 % increase in risk. Curiously, moderately high intake of n-6 PUFA (4–5 % of total daily energy) was associated with a 12 % reduction in IFG and IGT incidence.
MUFA, n-3 and n-6 FA contribute differently to the development of isolated IFG v. IFG with IGT; and their mechanism may be more complex than originally proposed.