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Light and intermittent smokers (LITS) represent almost 50% of all current smokers. Research is needed to understand smoking motives among adult light smokers.
To explore smoking cues and motivators among a racially diverse sample of adult LITS (≤10 CPD). In addition, we explored differences between native (always smoked ≤10), and converted (former heavier) LITS.
We used purposive sampling to recruit participants who were native and converted LITS and to include equal numbers of African Americans, Whites and Latinos. We coded and analyzed transcripts using a stage approach to identify themes.
Four main themes emerged that may be unique to light smokers and suggests potential strategies for intervention: (1) smoking in response to cues and control, (2) identifying as a smoker, (3) concern about health consequences, and (4) other priorities influencing smoking. There were some differences among smoking cues and motivators by race and ethnicity, and differences between native and converted LITS.
Overall, LITS reported drivers of smoking that were unrelated to symptoms of nicotine withdrawal. Even when experiencing salient cues, our LITS cohort expressed the ability to assert control over smoking by abstaining when situational contexts made smoking inconvenient.
This paper presents a novel neural architecture capable of outperforming state-of-the-art systems on the task of language variety classification. The architecture is a hybrid that combines character-based convolutional neural network (CNN) features with weighted bag-of-n-grams (BON) features and is therefore capable of leveraging both character-level and document/corpus-level information. We tested the system on the Discriminating between Similar Languages (DSL) language variety benchmark data set from the VarDial 2017 DSL shared task, which contains data from six different language groups, as well as on two smaller data sets (the Arabic Dialect Identification (ADI) Corpus and the German Dialect Identification (GDI) Corpus, from the VarDial 2016 ADI and VarDial 2018 GDI shared tasks, respectively). We managed to outperform the winning system in the DSL shared task by a margin of about 0.4 percentage points and the winning system in the ADI shared task by a margin of about 0.2 percentage points in terms of weighted F1 score without conducting any language group-specific parameter tweaking. An ablation study suggests that weighted BON features contribute more to the overall performance of the system than the CNN-based features, which partially explains the uncompetitiveness of deep learning approaches in the past VarDial DSL shared tasks. Finally, we have implemented our system in a workflow, available in the ClowdFlows platform, in order to make it easily available also to the non-programming members of the research community.
Palliative social workers have taken steps to increase the numbers of social workers trained and competent to deliver effective psychosocial palliative care. Despite these developments, masters of social work (MSW) programs have only begun to develop curricula preparing students for entry-level practice. This study sought to determine the type and extent of content areas included in MSW courses dedicated to palliative care or with content related to palliative care practice.
A cross-sectional study using an online questionnaire was conducted. All 248 accredited MSW programs in the United States and 32 programs in Canada were invited to participate. Participants were asked to name the courses in their MSW program that were dedicated to, or included content on, palliative care, and submit the syllabi for these courses. Data comprised course content for each class session and required readings. A grounded theory approach was used to identify the topics covered.
Of the 105 participating programs that responded to the survey, 42 submitted 70 syllabi for courses with at least some palliative care content. There were 29 topics identified. The most common topic was grief, loss, and bereavement, followed closely by behavioral and mental health issues, and supporting family and friends; cultural perspectives and advance care planning were also common topics. For the 10 syllabi from courses dedicated to palliative care, supporting family was the most common topical area, followed closely by interprofessional practice and advance care planning.
Significance of results
Although there are many challenges to introducing palliative care content into MSW programs, including unqualified faculty and competing course material and electives of equally compelling content, there are model curricula for dedicated palliative care courses. With the large growth of palliative care programs, the time is ripe to add specialty palliative care courses and to add palliative care content into existing courses.
It is time that all patients with acute-onset psychosis are screened for autoimmune encephalitis, that lumbar puncture becomes a routine psychiatric investigation and that immunotherapy is available in indicated cases. We call for a culture change in the management of psychosis by psychiatry.
Introduction: Hypertension is common and a major cause of morbidity and mortality. Because it is asymptomatic, its diagnosis is often delayed. For many Canadians the Emergency Department (ED) is the only point of entry to the health care system, and therefore the recognition of undiagnosed and untreated hypertension in the ED is increasingly important. This study sought to evaluate the prevalence and severity of hypertension in patients presenting to Calgary area EDs, as well as to determine whether medical therapy was initiated and if patients had primary care providers for follow-up. Methods: Multi-centre electronic medical record (EMR) review of all adult patients presenting to Calgary area EDs from January 1, 2016 to December 31st, 2016. Hypertension was coded electronically by triage nurses and defined as systolic blood pressure SBP 140 mmHg and/or diastolic blood pressure DBP 90 mmHg. Hypertensive urgency was defined as SBP 180 mmHg and/or DBP 120 mmHg. Descriptive data was used to show patient demographics and hypertension prevalence. Primary care provider status, previous diagnosis of hypertension, chief complaint, and ED diagnoses were extracted and the EMRs were manually searched to determine whether treatment was initiated in the ED. Results: Of 304392 patients presenting to all Calgary sites, 43055 (14%) were found to have hypertension; mean age 52 (range 18 to 104), female 42%. Of these, 32986 (77%) had no known previous hypertension and 31% lacked a primary care provider. 0.2% had documentation of treatment initiated in the ED. 16% met criteria for hypertensive urgency. Conclusion: Many patients presenting to the ED have hypertension, often previously undiagnosed and at times severe. Many lack access to primary care. EDs may play an important role in the early recognition of hypertension. Dedicated management and follow-up pathways are indicated for this high-risk population.
This manuscript provides a global perspective on physician and nursing education and training in paediatric cardiac critical care, including available resources and delivery of care models with representatives from several regions of the world including Africa, Israel, Asia, Australasia, Europe, South America, and the United States of America.
Individuals who have experienced high levels of childhood stress are at increased risk for a wide range of behavioral problems that persist into adulthood, yet the neurobiological and molecular mechanisms underlying these associations remain poorly understood. Many of the difficulties observed in stress-exposed children involve problems with learning and inhibitory control. This experiment was designed to test individuals' ability to learn to inhibit responding during a laboratory task. To do so, we measured stress exposure among a community sample of school-aged children, and then followed these children for a decade. Those from the highest and lowest quintiles of childhood stress exposure were invited to return to our laboratory as young adults. At that time, we reassessed their life stress exposure, acquired functional magnetic resonance imaging data during an inhibitory control task, and assayed these individuals' levels of methylation in the FK506 binding protein 5 (FKBP5) gene. We found that individuals who experienced high levels of stress in childhood showed less differentiation in the dorsolateral prefrontal cortex between error and correct trials during inhibition. This effect was associated only with childhood stress exposure and not by current levels of stress in adulthood. In addition, FKBP5 methylation mediated the association between early life stress and inhibition-related prefrontal activity. These findings are discussed in terms of using multiple levels of analyses to understand the ways in which adversity in early development may affect adult behavioral adaptation.
A crucial year for Osip Mandel'shtam was 1930: it was in October of that year, in Tiflis, on the way back from Armenia, that poetry returned to him, after five years during which he wrote almost no verse. The Armenia poems (numbers 203-218) are among the first of the “new verse,” and, with their theme of penance for unproductivity and attempt to transform the factors of disturbance—the sense of limitation, confinement, deprivation—into sources of new energy, they testify to Mandel'shtam's current concern with the operations of his work. Moreover, at this juncture Mandel'shtam gives programmatic attention to the principles of his writing.
Recent research in the field of child maltreatment has begun to shed new light on the emergence of health problems in children by emphasizing the responsiveness of developmental processes to children's environmental and biological contexts. Here, I highlight recent trends in the field with an emphasis on the effects of early life stress across multiple levels of developmental domains.
Physically maltreated children are at risk for developing externalizing behavioral problems characterized by reactive aggression. The current experiment tested the relationships between individual differences in a neural index of social information processing, histories of child maltreatment, child negative affect, and aggressive behavior. Fifty boys (17 maltreated) performed an emotion recognition task while the P3b component of the event-related potential was recorded to index attention allocation to angry faces. Children then participated in a peer-directed aggression task. Negative affect was measured by recording facial electromyography, and aggression was indexed by the feedback that children provided to a putative peer. Physically maltreated children exhibited greater negative affect and more aggressive behavior, compared to nonmaltreated children, and this relationship was mediated by children's allocation of attention to angry faces. These data suggest that physical maltreatment leads to inappropriate regulation of both negative affect and aggression, which likely place maltreated children at increased risk for the development and maintenance of externalizing behavior disorders.
We conducted an experiment to determine whether early-life social learning of feeding site selection in lambs was sex-specific. Sixteen ewes and their new born lambs were used in a controlled experiment. Eight ewe–lamb pairs included a male lamb and the remaining eight a female lamb. All pairs were individually exposed to an experimental arena containing a safe and unsafe artificial feeding site (SFS, UFS) each consisting of nine bowls which contained either ground Bermuda grass hay (SFS) or ground alfalfa hay (UFS). The bowls in UFS were surrounded by bright orange traffic cones (visual cues). Half the ewes were trained with controlled electric shock to avoid UFS. Thus, pairs were randomly assigned to: (1) shock aversion training (SAT) to mothers of male lambs (MS); (2) SAT to mothers of female lambs (FS); (3) no aversion training (NAT, control) to mothers of male lambs (MC); and (4) NAT (control) to mothers of female lambs (FC). None of the lambs were subjected to SAT. During training, testing, extinction, and retraining ewe–lamb pairs were exposed to the arena together. Ewes were then removed from the experiment and two additional extinction phases were conducted with weaned lambs alone. Fear conditioning elicited UFS avoidance of both the trained ewes (means±s.e.m. % times observed in UFS during testing phase: FC=95.3±1.70; MC=94.4±4.87; FS=1.6±1.63; MS=0 ±0; P<0.01) and their naïve lambs (FC=83.8±6.07%; MC=76.6±6.56%; FS=30.4±7.90%; MS=33.9±9.23%; P<0.01). UFS avoidance in lambs occurred regardless of sex and tended to persist after weaning (% times observed in UFS during 1st post-weaning extinction phase: FC=92.6±4.50%; MC=89.8±6.09%; FS=45.1±10.57%; MS=43.5±10.42%; P=0.06). Fear conditioning in mothers appeared to alter sex-related differences in mother–infant behavioral synchrony by increasing and decreasing feeding synchrony of male and female lambs, respectively (FC: r=0.52, P<0.01; MC: r=−0.02, P=0.86; FS: r=0.14, P=0.26; MS: r=0.46, P<0.01). During the extinction phase mothers of ram lambs were observed feeding more often (FC=85.0±2.33%; MC=92.7±1.45%; FS=47.3±8.81%; MS=72±5.68%; P=0.02) and standing less often than ewes with daughters (FC=7.3±2.40%; MC=2.7±0.83%; FS=39.3±9.04%; MS=18.0±5.29%; P=0.06). This study suggests that social conditioning at an early age could be a viable tool to induce learning of feeding site avoidance in female and male lambs alike.
Insulin and insulin-like growth factors (IGFs) are potent mitogens, and the hypothesis that their receptors are important therapeutic targets in oncology has received considerable attention (reviewed in 1–5). In the last decade, more than 20 drug candidates that target IGF receptors or both insulin and IGF receptors have been developed. Of these, at least 12 have been taken forward to clinical trials.
The rationale for drug development in this area included clinical and epidemiologic evidence (for example 6,7) that circulating levels of insulin and/or IGFs are related to cancer risk and/or cancer prognosis, as well as laboratory studies (for example 8) which demonstrated that interfering with signaling had inhibitory effects on neoplastic behavior. Seminal studies (9) from the laboratory of Renato Baserga showing a requirement for presence of the IGF-I receptor for transforming activity of a variety of oncogenes also contributed to the rationale. This research was followed by laboratory studies of drug candidates that demonstrated activity (for examples 1,2,4,5), which then led to clinical trials. In retrospect, however, it must be recognized that most pre-clinical studies of drug candidates showed benefit in experimental cancer models engineered to be IGF-IR driven, or in models chosen specifically because they were sensitive to the drugs, with relatively little attention being given to studies of tumor or host characteristics that predicted activity.
Anti-N-methyl-d-aspartate (NMDA) receptor encephalitis is an autoimmune condition caused by immunoglobulin (Ig)G antibodies directed against the NR1 subunit of the NMDA glutamate receptor. Approximately 65% of cases present with psychiatric symptoms, particularly psychosis. It remains to be established whether anti-NMDA receptor antibodies can cause a ‘purely’ psychotic illness without overt neurological symptoms.
We conducted a systematic literature search to establish what proportion of patients with schizophrenia and related psychoses have antibodies directed against the NMDA receptor. Studies were included if (a) subjects had a diagnosis of schizophrenia, schizophrenia spectrum disorder or first-episode psychosis (FEP) using standard criteria, (b) serum was analysed for the presence of anti-NMDA receptor antibodies; and (c) the purpose of the study was to look for the presence of anti-NMDA receptor antibodies in patients with a primary psychiatric diagnosis without clinical signs of encephalitis.
Seven studies were included, comprising 1441 patients, of whom 115 [7.98%, 95% confidence interval (CI) 6.69–9.50] were anti-NMDA receptor antibody positive. Of these, 21 (1.46%, 95% CI 0.94–2.23) patients were positive for antibodies of the IgG subclass. Prevalence rates were greater in cases than controls only for IgG antibodies; other subclasses are of less certain aetiological relevance. There was significant heterogeneity in terms of patient characteristics and the antibody assay used.
A minority of patients with psychosis are anti-NMDA receptor antibody positive. It remains to be established whether this subset of patients differs from antibody-negative patients in terms of underlying pathology and response to antipsychotic treatment, and whether immunomodulatory treatments are effective in alleviating psychotic symptoms in this group.
We consider the flow of a viscous liquid along an unknown topography. A new strategy is presented to reconstruct the topography and the free surface shape from one component of the free surface velocity only. In contrast to the classical approach in inverse problems based on optimization theory we derive an ordinary differential equation which can be solved directly to obtain the inverse solution. This is achieved by averaging the Navier–Stokes equation and coupling the function parameterizing the flow domain with the free surface velocity. Even though we consider nonlinear systems including inertia and surface tension, the inverse problem can be solved analytically with a Fourier series approach. We test our method on a variety of benchmark problems and show that the analytical solution can be applied to reconstruct the flow domain from noisy input data. It is also demonstrated that the asymptotic approach agrees very well with numerical results of the Navier–Stokes equation. The results are finally confirmed with an experimental study where we measure the free surface velocity for the film flow over a trench and compare the reconstructed topography with the measured one.
The previous chapters described the unusual electronic phenomena brought about by disorder and interaction and how they can be understood at least qualitatively. To conclude this book, a number of open questions and possible future research directions are addressed. These demonstrate that the field of electron glass is far from being closed and that some of its major issues are not understood or are under debate. First and foremost, there exists no statistical or thermodynamic theory of nonergodic systems, and for that reason there is no full understanding of any glasses – less so of quantum glasses such as is the electron glass. Indeed, the purpose of this book is to present a comprehensive review of the current state of the field, with the anticipation that further experimental, theoretical, and numerical work will follow and help elucidating the issues that remain unclear today.
• Processes responsible for glassy properties At the present, there is no consensus as to the electronic processes that lead to long relaxation and memory phenomena. Does the glassy behavior require many-electron transitions or are single hops enough? Is it only very low energy transitions that linger at very long times? The proposed suggestions for the slow relaxation of conductivity are slow formation of the Coulomb gap, slow formation of quasi-particles, slow manyelectron transitions off the percolation path affecting the paths, many-electron transitions traversing the current carrying path, exchange of particles between the percolation path and clusters off the path, all as discussed in Chapter 7.
Chapter 3 serves as an introduction to glasses and in doing so focuses on what is characteristic of glasses in general. To briefly summarize, the phenomenological common features are an extremely long or perpetual state of nonequilibrium, disobeying time homogeneity (aging), and memory effects. Structurally, the common features are interaction and disorder, the combination of which leads to frustration. As far as experiments are concerned, one can excite the glass with some generalized force – thermodynamically an intensive quantity – and measure a responding dynamical variable (an extensive quantity) or a generalized susceptibility. For example, in structural glasses, one measures deformation or viscosity responding to stress, in spin glasses one measures magnetization or magnetic susceptibility responding to applied magnetic fields, and in electron glasses one measures conductivity or electrical susceptibility in response to applied electric fields. Alternatively, one can measure slow relaxation of this variable after cooling from high temperature.
In relation to Chapter 3, this chapter is primarily intended to point out the more subtle differences between the electron glass and other glasses, with some particular attention to the spin glass, which is a close relative of the electron glass and is the most widely studied glass.
Before all else, it is useful to start with structural glasses, which, in more than one sense, is the mother of other glasses. The silica glass (“window glass”) is by far the oldest glass that humans took interest in, mainly as an object of fashion.