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The objective of this study was to derive a factor structure of the measures of the National Institutes of Health (NIH) Toolbox Cognition Battery (CB) that is representative of cognitive abilities in a large ethnically diverse cohort of 8-year-old children in Aotearoa New Zealand.
Our sample comprised of 4298 8-year-old children from the Growing Up in New Zealand study. We conducted exploratory and confirmatory factor analysis for the NIH Toolbox CB measures to discover the best-fitting factor structure in our sample. Measurement invariance of the identified model was tested across child’s gender, socio-economic status (SES), and ethnicity.
A three-dimensional factor structure was identified, with one factor of Crystallised Cognition (Reading and Vocabulary), and two distinguished factors of fluid cognition: Fluid Cognition I (Attention/Inhibitory Control, Processing Speed, and Cognitive Flexibility) and Fluid Cognition II (Working Memory, Episodic Memory). The results demonstrate excellent model fit, but reliability of the factors was low. Measurement invariance was confirmed for child’s gender. We found configural, but neither metric nor scalar, invariance across SES and the four major ethnic groups: European, Māori, Pacific Peoples, and Asian.
Our findings show that, at the age of 8 years, fluid abilities are more strongly associated with one another than with crystallised abilities and that fluid abilities need to be further differentiated. This dimensional structure allows for comparisons across child’s gender, but evaluations across SES and ethnicity within the Aotearoa New Zealand context must be conducted with caution. We recommend using raw scores of the individual NIH Toolbox CB measures in future research.
Several aspects led to the poor control of the coronavirus disease 2019 (COVID-19) outbreak in the US from a rural emergency department (ED) perspective. These include US residents’ attitude towards political involvement in health and civil rights; lack of enough testing kits and rapid test results, or not available at all; and personal protective equipment (PPE) shortages. These obstacles related to medical supplies and resources, and lack of coordinated approach to the pandemic in the US, are important information for retrospective disaster research to understand study limitations, extrapolate accurate and valid data, and for other countries to understand how and why the US had higher numbers of COVID-19 cases and deaths compared to other countries.
Currently, no separate service exists for patients with young-onset dementia in Cambridgeshire. These patients are managed together with late-onset dementia patients within old age psychiatry services. To inform service design, we sought to characterise young-onset dementia patients in our population. We first analysed service-level data and supplemented this with a detailed case review of 90 patients.
Young-onset dementia remains a relatively rare condition. Only a small proportion of those referred for assessment receive a diagnosis of dementia. Data collected on presenting complaints, comorbidities, medication and Health of the Nation Outcome Scales scores associated young-onset dementia with a greater incidence of depression than late-onset dementia. Outcomes in the two groups did not appear to differ.
The data presented here do not suggest a need to create a separate service. Practitioners should be aware of the increased incidence of depression observed in this group.
Almost as soon as Paris was liberated from Nazi Occupation on 25 August 1944, Yiddish actors took back the stages on which they had once performed. In fact, on 20 December 1944, while war and the Holocaust still raged, a small cohort of actors produced what they advertised in the Naye prese as the “first grand performance by the ‘Yiddish folks-bine.’” This performance was to take place at the four-hundred-seat Théâtre Lancry, a performance space located in Paris's 10th arrondissement, not far from the Place de la République and the Marais. “Lancry,” as it was known, had played host to Yiddish theatre as early as 1903 and, during the interwar years, it was the center of Parisian Yiddish cultural activity: dozens of theatre performances occurred there and it was where the Kultur-lige pariz was based, among other institutions. During the postwar years, it also went by the name Théâtre de la République after 1947 and Théâtre du Nouveau-Lancry after 1951, but many still referred to it simply as “Lancry.”
For several decades, mental health services within the UK's National Health Service were provided by specialist mental health trusts. More recently many of these trusts have integrated community physical health services into their operations. We describe here how two integrated mental health trusts in England were able to make an enhanced response to the COVID-19 pandemic.
In this paper, we characterize a high repetition-rate regenerating plasma mirror produced by the thin film of liquid formed when two laminar streams collide. The use of a flowing liquid film is inexpensive and the interaction surface refreshes automatically, avoiding buildup of on-target debris. The composition of the liquid material and the relative angle of the film-generating nozzles was optimized for this application. Spectra measured in reflection from a water-based plasma mirror showed a blue shift but an optical reflectivity of up to 30%. The thickness of the film was found to be of the order of 2
m, and the stability of the reflected spot was
mrad. The reflected beam profile was highly distorted but stable. Further optimization of the nozzles to affect the fluid flow should enable significant improvements in control of the fluid films and increase in the reflectivity of these mirrors.
Stratified medicine has been successfully used in many areas of medicine, perhaps most notably oncology. There is now both a growing evidence base and mounting enthusiasm, supported at a governmental level and across industry, academia and clinical medicine, to apply this approach to neurodegenerative illnesses, including dementia, as these provide the greatest clinical and social challenge of our times. In this article we consider definitions of stratified medicine, look at its application in other medical specialties, review the national context in the UK and consider the current state, future potential and specific considerations of applying stratified medicine to dementia.
A key factor in the transition to psychosis is the appraisal of anomalous experiences as threatening. Cognitive models of psychosis have identified attentional and interpretative biases underlying threat-based appraisals. While much research has been conducted into these biases within the clinical and cognitive literature, little examination has occurred at the neural level. However, neurobiological research in social cognition employing threatening stimuli mirror cognitive accounts of maladaptive appraisal in psychosis. This review attempted to integrate neuroimaging data regarding social cognition in psychosis with the concepts of attentional and interpretative threat biases. Systematic review methodology was used to identify relevant articles from Medline, PsycINFO and EMBASE, and PubMed databases. The selective review showed that attentional and interpretative threat biases relate to abnormal activation of a range of subcortical and prefrontal structures, including the amygdala, insula, hippocampus, anterior cingulate, and prefrontal cortex, as well as disrupted connectivity between these regions, when processing threatening and neutral or ambiguous stimuli. Notably, neural findings regarding the misattribution of threat to neutral or ambiguous stimuli presented a more consistent picture. Overall, however, the findings for any specific emotion were mixed, both in terms of the specific brain areas involved and the direction of effects (increased/decreased activity), possibly owing to confounds including small sample sizes, varying experimental paradigms, medication, and heterogeneous, in some cases poorly characterised, patient groups. Further neuroimaging research examining these biases by employing experimentally induced anomalous perceptual experiences and well-characterised large samples is needed for greater aetiological specificity.
Autism spectrum disorder (ASD) affects 20–30% of adults with intellectual disability. This group are vulnerable to challenging behaviour and mental health problems.
To explore the extent to which ASD affects challenging behaviour among specialist mental health service users with intellectual disability.
To identify predictors of challenging behaviour among adults who have intellectual disability.
A cross-sectional study of 92 participants from a specialist mental health service for adults with intellectual disability in the UK. The presence/absence of ASD was confirmed using the Autism Diagnostic Observation Schedule. Challenging behaviour was assessed using the Developmental Behaviour Checklist (DBC).
Participants with ASD (N=48) had higher total DBC scores than those without ASD (N=44; mean=54.2 vs. 29.2). ASD, severity of intellectual disability, age, presence of psychiatric disorder and total number of needs were entered as independent variables into a linear regression. The model accounted for 51% of the variance and was statistically significant (F(5,91)=18.1, p<0.001). Presence of ASD and total number of needs were the only significant predictors of challenging behaviour. Presence of ASD had the highest standardised coefficient (β=0.56).
Participants with ASD had significantly higher levels of challenging behaviour than those without ASD. Challenging behaviour was also independently associated with total number of needs. Understanding which service users with intellectual disability have higher levels of challenging behaviour than others despite receiving psychiatric treatment, and the extent to which having ASD is a contributing factor, should inform the development of more effective services and lead to improved outcomes.
The provision of support for people with autism spectrum disorder (ASD) within the community is improving as a consequence of policy and legislative changes. However, specialist services are not currently provided in prisons.
This aim of the study was to determine the extent of ASD and co-occurring mental health problems among prisoners. We tested the hypothesis that ASD traits would be unrecognised by prison staff and would be significantly associated with increased rates of anxiety, depression and suicidality.
ASD traits were measured among 240 prisoners in a resettlement prison in London, UK using the 20-item Autism Quotient (AQ-20). Anxiety, depression and suicidality were assessed using the Mini International Neuropsychiatric Interview (MINI).
There were 39 participants (16%) with an AQ-20 score ≥10; indicating significant autistic traits. Mental health data were available for 37 ‘high autistic trait’ participants and another 101 prisoners with no/low ASD traits. There was a significant positive association between AQ-20 and suicidality scores (r=.29, p=0.001). Participants with ASD traits had significantly higher suicidality scores (means=15.1 vs. 5, p= 0.001) and chi-square analysis showed that they were more likely to have a high suicidality rating (27% vs. 8%, p=0.003) than those without ASD traits. Moreover, those with ASD were significantly more likely to be experiencing a current episode of depression (30% vs. 6%, p<0.001) or Generalised Anxiety Disorder (GAD) (27% vs. 11% p=0.019).
Our initial data suggests that severity of ASD traits is a risk factor for suicidality and common mental health problems among prisoners.
To establish whether a dementia intensive support (DIS) service that is part of a crisis resolution and home treatment team for older people is preventing admissions to acute hospital and psychiatric wards. The number of referrals in 2017 to the DIS service was established and those admitted to hospital ascertained. Senior doctors examined 30 sets of notes in detail and reached a conclusion on whether DIS had contributed to admission prevention. This information was then re-examined in two meetings with at least eight senior psychiatrists present. A consensus opinion was then reached as to whether DIS had contributed to admission prevention in each case.
Over 12 months, 30/171 patients (18%) referred were admitted to hospital. For the subset of 30 referrals examined in detail, DIS contributed to admission avoidance in 21 cases (70%).
Our evaluation demonstrates that the DIS service is an effective way of preventing admission.
The Health of the Nation Outcomes Scales (HoNOS) has been widely used as an outcome measure in UK mental health settings for the past decade. The data-set gathered provides a unique opportunity to evaluate the effectiveness of the totality of mental healthcare in ‘real-world’ conditions; much of our clinical evidence currently comes from highly parameterised clinical trials investigating single interventions in highly selected patients.
To examine all outcomes measured by HoNOS for a range of diagnostic groups, evaluate the influence of patient demographics on those outcomes, and observe changes in patient groups over time.
Here we show the data from 6813 adult patients treated in Cambridgeshire between 2012 and 2017. Patients were split into three diagnostic groups: psychosis, non-psychosis and organic. Changes in HoNOS scores from initial assessment to discharge were tested and regressions were used to evaluate the influence of age, gender and ethnicity on the changes, as well as to model changes in the severity of initial presenting symptoms with time.
HoNOS scores significantly improve after treatment for psychotic, non-psychotic and organic conditions in adults and older adults. Age, but not gender or ethnicity, influenced change in HoNOS scores. Patients entering secondary mental health services had increased initial HoNOS scores over time.
The UK repository of HoNOS scores provides a significant and relatively underutilised resource that can be exploited to gain insights into mental illness and treatment effectiveness. This is likely to have many applications, including influencing the commissioning of services.
Numbers appear to have limited value for literary study, since our discipline is usually more concerned with exploring differences of interpretation than with describing the objective features of literary works. But it may be time to reexamine the assumption that numbers are useful only for objective description. Machine learning algorithms are actually bad at being objective and rather good at absorbing human perspectives implicit in the evidence used to train them. To dramatize perspectival uses of machine learning, I train models of genre on groups of books categorized by historical actors who range from Edwardian advertisers to contemporary librarians. Comparing the perspectives implicit in their choices casts new light on received histories of genre. Scientific romance and science fiction—whose shifting names have often suggested a fractured history—turn out to be more stable across two centuries than the genre we call fantasy. (TU)
The flat oyster Ostrea edulis has declined significantly in European waters since the 1850s as a result of anthropogenic activity. Ostrea edulis was designated a UK Biodiversity Action Plan Species and Habitat in 1995, and as a Feature of Conservation Importance (FOCI) within the UK Marine & Coastal Access Act 2009. To promote the recovery of oyster beds, a greater understanding of its abundance and distribution is required. Distribution of O. edulis across the proposed Blackwater, Crouch, Roach and Colne MCZ in Essex was determined between 2008 and 2012. Ostrea edulis were present in four estuary zones; with highest sample abundance in the Blackwater and Ray Sand zones. Size structure of populations varied, with the Ray Sand and Colne zones showing a significant lack of individuals with shell height <39 mm. Ostrea edulis occurred in highest number on shell substratum, followed by silty sediments. There were no significant associations between O. edulis abundance or size structure with water column Chl a, suspended solids, oxygen, nitrate or ammonium concentrations, temperature or pH. Highest abundance and most equitable population shell-size distribution for O. edulis were located within, or adjacent to, actively managed aquaculture zones. This suggests that traditional seabed management contributed to the maintenance or recovery of the species of conservation concern. Demonstration that the Essex estuaries were a stronghold for Ostrea edulis in the southern North sea area led to the designation of the Blackwater, Crouch, Roach and Colne estuaries Marine Conservation Zone in 2013.
The rocky shores of New Zealand (NZ) and Australia provide many interesting comparisons in their intertidal species and structuring processes. Both countries are in the biogeographic realm of temperate Australasia and share many common species and closely related taxa. Here we review similarities and contrasts in communities and structuring processes, especially involving grazing invertebrates and macroalgae. We consider the similarity of the structure of intertidal shores of NZ and south-eastern Australia, a suite of important trophic interactions within and between regions, the utility of local-scale experiments in understanding large-scale processes and how we might better plan for and manage our coasts. The major comparisons are between warm-temperate areas of northern NZ and New South Wales, and the cooler areas of southern NZ and south-eastern Australia. In the quest for ‘ecosystem’-level understanding, which perforce involves large-scale events, there is an increasing tendency to minimise or ignore the hard-won insights gained from well-structured experiments across multiple sites. Because all large-scale effects must be manifested at local sites, it is incumbent on us to determine what scales up or down, and the caveats that make comparisons across biogeographic regions challenging. Here, we discuss these issues using austral shores as models.
Intertidal biofilms are a diverse mixture of bacteria, algae as well as sporelings of macroalgae embedded in a polysaccharid matrix. As the primary colonisers of newly formed surfaces, biofilms undergo a succession of different microbe assemblage until the mature state is reached. A biofilm can act as primary producers and as such recycle nutrients in a habitat. It will influence macrobiota by providing a food source or sending out cues to settlers. Biofilms themselves will be controlled by these settlers. This interaction between bottom-up and top-down plays a crucial part for the functioning of the rocky shore ecosystems. However, the diversity of biolfilms as well as it nature to react quickly to environmental changes makes identification and quantification of the individual compounds a difficult task. Subsequently, the understanding of biofilms in general and intertidal, rocky shore microbe assemblages has always tied to techniques and methods available at the time of study. This chapter focusses on the techniques that have greatly contributed to increasing knowledge of biofilms and discusses their findings. Nonetheless, newly developed methods promise to further this knowledge of the ecological role of biofilms on rocky coastlines.
Adolescents’ peer networks provide an important context that can contribute to increases in antisocial behavior. By a process called deviancy training, peers can both model and reinforce these behaviors, thereby conveying group norms about the acceptability of such behaviors. This research examined the relationship between the proportion of adolescents’ peers who exchanged antisocial text messages and externalizing behaviors during high school. In Study 1, parent-, teacher-, and self-reports of rule-breaking and aggression were collected for a sample of adolescents (n = 167, 80 girls; 22.2% Black, 51.5% Caucasian, 18.7% Hispanic) during the summers before and after 9th grade. Total text frequency, frequency of antisocial texts, and the proportion of the peer network who exchanged antisocial messages were examined as predictors of antisocial behavior. The proportion of peers who exchanged antisocial texts significantly predicted rule-breaking, but not aggression. Study 2 examined the direction of the relationship documented in Study 1 more thoroughly. Externalizing behaviors at 9th, 10th, and 11th grade were evaluated as predictors of the proportion of the peer network that exchanged texts about antisocial topics (n = 205, 98 girls; 22.4% Black, 53.7% Caucasian, 16.9% Hispanic). Externalizing behaviors predicted the proportion of adolescents’ peer network that exchanged antisocial texts in each of the subsequent years, but this proportion of the peer network exchanging antisocial communication did not predict subsequent externalizing behaviors. The findings suggest that the extent to which antisocial communication permeates the peer group is a selection effect.
We use the introduction of direct flights as an exogenous shock to the travel time between mutual funds and firms to estimate the causal effects of proximity on fund investment decisions and performance. We find that a fund invests significantly more in firms that become more proximate following the introduction of direct flights and that these more proximate investments exhibit superior performance. Our findings are robust to including a variety of fixed effects and potential confounders such as firm-level shocks, fund-level shocks, and time trends. Collectively, our results indicate that proximity enhances investors’ ability to acquire value-relevant information about firms.