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The Belfast Ramped Pyroxidation/Combustion (RPO/RC) facility was established at the 14CHRONO Centre (Queen’s University Belfast). The facility was created to provide targeted analysis of bulk material for refined chronological analysis and carbon source attribution for a range of sample types. Here we report initial RPO results, principally on background material, but also including secondary standards that are routinely analyzed at 14CHRONO. A description of our setup, methodology, and background (blank) correction method for the system are provided. The backgrounds (anthracite, spar calcite, Pargas marble) reported by the system are in excess of 35,000 14C years BP with a mean age of 39,345 14C years BP (1σ = 36,497–43,800 years BP, N=44) with F14C = 0.0075 ± 0.0032. Initial results for standards are also in good agreement with consensus values: TIRI-B pine radiocarbon age = 4482 ± 47 years BP (N=13, consensus = 4508 years BP); IAEA-C6 ANU Sucrose F14C= 1.5036 ± 0.0034 (N=10, consensus F14C = 1.503). These initial tests have allowed problematic issues to be identified and improvements made for future analyses.
We evaluated adverse drug events (ADEs) by chart review in a random national sample of 428 veterans with coronavirus disease 2019 (COVID-19) who received tocilizumab (n = 173 of 428). ADEs (median time, 5 days) occurred in 51 of 173 (29%) and included hepatoxicity (n = 29) and infection (n = 13). Concomitant medication discontinuation occurred in 22% of ADE patients; mortality was 39%.
The Chinese culture of filial piety has historically emphasised children's responsibility for their ageing parents. Little is understood regarding the inverse: parents’ responsibility and care for their adult children. This paper uses interviews with 50 families living in rural China's Anhui Province to understand intergenerational support in rural China. Findings indicate that parents in rural China take on large financial burdens in order to sustain patrilineal traditions by providing housing and child care for their adult sons. These expectations lead some rural elders to become migrant workers in order to support their adult sons while others provide live-in grandchild-care, moving into their children's urban homes or bringing grandchildren into their own homes. As the oldest rural generations begin to require ageing care of their own, migrant children are unable to provide the sustained care and support expected within the cultural tradition of xiao. This paper adds to the small body of literature that examines the downward transfer of support from parents to their adult children in rural China. The authors argue that there is an emerging cultural rupture in the practice of filial piety – while the older generation is fulfilling their obligations of upbringing and paying for adult children's housing and child care; these adult children are not necessarily available or committed to the return of care for their ageing parents. The authors reveal cultural and structural lags that leave millions of rural ageing adults vulnerable in the process of urbanisation in rural China.
The Late Triassic fauna of the Lossiemouth Sandstone Formation (LSF) from the Elgin area, Scotland, has been pivotal in expanding our understanding of Triassic terrestrial tetrapods. Frustratingly, due to their odd preservation, interpretations of the Elgin Triassic specimens have relied on destructive moulding techniques, which only provide incomplete, and potentially distorted, information. Here, we show that micro-computed tomography (μCT) could revitalise the study of this important assemblage. We describe a long-neglected specimen that was originally identified as a pseudosuchian archosaur, Ornithosuchus woodwardi. μCT scans revealed dozens of bones belonging to at least two taxa: a small-bodied pseudosuchian and a specimen of the procolophonid Leptopleuron lacertinum. The pseudosuchian skeleton possesses a combination of characters that are unique to the clade Erpetosuchidae. As a basis for investigating the phylogenetic relationships of this new specimen, we reviewed the anatomy, taxonomy and systematics of other erpetosuchid specimens from the LSF (all previously referred to Erpetosuchus). Unfortunately, due to the differing representation of the skeleton in the available Erpetosuchus specimens, we cannot determine whether the erpetosuchid specimen we describe here belongs to Erpetosuchus granti (to which we show it is closely related) or if it represents a distinct new taxon. Nevertheless, our results shed light on rarely preserved details of erpetosuchid anatomy. Finally, the unanticipated new information extracted from both previously studied and neglected specimens suggests that fossil remains may be much more widely distributed in the Elgin quarries than previously recognised, and that the richness of the LSF might have been underestimated.
North Carolina Central University (NCCU) and Duke Cancer Institute implemented an NCI-funded Translational Cancer Disparities Research Partnership to enhance translational cancer research, increase the pool of underrepresented racial and ethnic group (UREG) researchers in the translational and clinical research workforce, and equip UREG trainees with skills to increase diversity in clinical trials. The Cancer Research Education Program (C-REP) provided training for UREG graduate students and postdoctoral fellows at Duke and NCCU. An innovative component of C-REP is the Translational Immersion Experience (TIE), which enabled Scholars to gain knowledge across eight domains of clinical and translational research (clinical trials operations, data monitoring, regulatory affairs, UREG accrual, biobanking, community engagement, community outreach, and high-throughput drug screening). Program-specific evaluative metrics were created for three broad domains (clinical operations, basic science/lab research, and population-based science) and eight TIE domains. Two cohorts (n = 13) completed pre- and post-surveys to determine program impact and identify recommendations for program improvement. Scholars reported statistically significant gains in knowledge across three broad domains of biomedical research and seven distinct areas within TIE. Training in translational research incorporating immersions in clinical trials operation, biobanking, drug development, and community engagement adds value to career development of UREG researchers.
The Triassic–Jurassic Upper Karoo Group of the Mid-Zambezi Basin (MZB; Zimbabwe) includes a thick succession of terrestrial sediments with high palaeontological potential that has been neglected since the 1970s. Here, we review the Upper Karoo Group stratigraphy, present detailed sedimentological work and identify new vertebrate-bearing sites at several measured sections along the southern shore of Lake Kariba. These fossil-bearing sites fall within the Pebbly Arkose and Forest Sandstone formations, and are the first to be recorded from the region since the discovery of Vulcanodon karibaensis nearly 50 years ago. The unique and diverse assemblage of aquatic and terrestrial fauna reported includes phytosaurs, metoposaurid amphibians, lungfish, non-dinosaurian archosauromorphs and non-sauropod sauropodomorph dinosaurs. This improvement of Upper Karoo Group biostratigraphy is important in refining its temporal resolution, and impacts both regional and global studies. Finally, the new fossil sites demonstrate the palaeontological importance of the MZB and its role in providing a holistic understanding of early Mesozoic ecosystems in southern Gondwana.
Systematic reviews and meta-analyses suggest that behaviour change interventions have modest effect sizes, struggle to demonstrate effect in the long term and that there is high heterogeneity between studies. Such interventions take huge effort to design and run for relatively small returns in terms of changes to behaviour.
So why do behaviour change interventions not work and how can we make them more effective? This article offers some ideas about what may underpin the failure of behaviour change interventions. We propose three main reasons that may explain why our current methods of conducting behaviour change interventions struggle to achieve the changes we expect: 1) our current model for testing the efficacy or effectiveness of interventions tends to a mean effect size. This ignores individual differences in response to interventions; 2) our interventions tend to assume that everyone values health in the way we do as health professionals; and 3) the great majority of our interventions focus on addressing cognitions as mechanisms of change. We appeal to people’s logic and rationality rather than recognising that much of what we do and how we behave, including our health behaviours, is governed as much by how we feel and how engaged we are emotionally as it is with what we plan and intend to do.
Drawing on our team’s experience of developing multiple interventions to promote and support health behaviour change with a variety of populations in different global contexts, this article explores strategies with potential to address these issues.
There are no large scale studies on Epilepsy in populations with Learning disability in Ireland. As many as one fifth of these clients have epilepsy. Aggressive treatment may lead to diminishing returns in terms of symptomatic control, while causing unwanted effects.
1. We aimed to quantify rates of epilepsy, aetiology and anti- epileptic drug (AED) use in our population.
2. To look at degree of disability and correlation with AED use.
3. To look at management/ quality of life issues using a validated instrument.
1. Medline review using search terms Intellectual OR Learning difficult* OR Mental Retard* AND Epilepsy.
2. Simple questionnaire used to identify all clients with Epilepsy. Database analysed using SPSS analysis.
3. 11 cases selected for review looking at qualitative aspects, using Semi structured interview and GEOS scale.
· 210 patients found to have a history of epilepsy (42% of clients).
· Multiple Aetiologies identified. Commonest known Aetiology: Trisomy 21.
· Polypharmacy is common. Most commonly used AED: Sodium Valproate. Mean AED use: 1.595 (SD+- 1.077).
· Clients with Trisomy 21 aged less than 40 tended to be on more medication (2.05, SD= +-1.38) than those over 40 years (1.43, SD= +- 0.89)
· Greater concerns on qualitative measures regarding clients with refractory epilepsy or where epilepsy changed over time.
Our study highlights previously recognised changing patterns in aetiology of Learning Disability and also the changes over time in these clients. More study is required.
The education and training of doctors specialising in Child and Adolescent Psychiatry (CAP) varies substantially across Europe. There is a paucity of information available about training quality. This prompted an initial training survey led by Dr E Barrett (2010) which was expanded upon by the CAP working group in the 2010 EFPT international forum in Dubrovnik to create ‘country reports’ for 2010–2011.
The objectives of this study were to collect information relating to key aspects of CAP training programmes in Europe in a systematic way in order to start a ‘Training Database’ that can be held centrally by the EFPT. Information will be added to the database every year following EFPT annual international meetings.
We aim to better understand the training structures in CAP across europe to help inform best practice standards for training.
A pro-forma word document was emailed to all EFPT CAP contacts: there were 20 contacts emailed.
So far we have a response rate of over 60% and we are continuing to collect and collate relevant data. This survey highlighted a large variation in CAP training across Europe. It represents the basis for systematic data collection on an international level, and will help focus on areas where CAP training could be improved.
This survey highlights a large variation in CAP training across Europe. It represents the basis for systematic data collection on an international level, and will help focus on areas where CAP training could be improved.
Training schemes in psychiatry are developed and evaluated by national education policy makers in the majority of European countries. However, the requirements that a training program in psychiatry should meet are also defined on the European level in a form of recommendations by the Board of Psychiatry - European Union of Medical Specialists (UEMS).
Recently, the European Federation of Psychiatric Trainees (EFPT) which represent trainees from more then 30 European countries, reported data pertaining to the structure of training programs and to the evaluation of training programs in 30 European countries. Whereas in the majority of European countries the structure of training programs and methods of assessment of trainees' competencies are partially compatible with one another and with the existing recommendations at the European level, the quality assurance of training programs varies significantly among countries. Regular evaluations of training programs and mentors, however, contribute to the proper implementation of training programs and help that the theoretical training principles are followed through in practice. As quality assurance of training schemes is an important mechanism how to improve the delivery of training programs, it should gain more focus by responsible authorities who structure the psychiatric training on the national and international European level.
The European Federation of Psychiatric Trainees (EFPT) is an independent federation of psychiatric trainees’ associations. Previous studies have shown that up to 1/3 of countries surveyed did not have separate CAP training We surveyed trainees to gain insights regarding current training within the member countries of the EFPT.
Ten item Survey of Trainee representatives from 32 countries- using surveymonkey questionnaire.
Industry standard encryption technology utilisied.
27 respondent countries. Response rate 84.4% In many countries CAP and General Adult Psychiatry training were not separate Variable availability of training posts (surplus posts 23%, no posts/ long waits 19.2%) Duration of training: 3 years (19.2%),4 years (23.1%), 5 years (26.9%). In 35% of countries CAP training was entirely separate from commencement of training. In 40%, entry to CAP training occurred after training in general adult psychiatry. Trainees in 61.5% of respondent countries indicate their intention to specialise in CAP before entering training in psychiatry; 15% of trainees can indicate this at any time.
This is a survey of trainee representatives to the EFPT of ten items related to CAP training experiences. It highlights significant differences in training experiences in 27 respondent countries. From 2010 the EFPT aims to record detailed information on CAP training yearly. CAP trainees are an integral part of EFPT, and there are specific areas of needs in CAP training.
The influence of pharmaceutical industry (PI) on clinical practice and research in psychiatry has been considered a serious problem. Strict rules and guidelines were developed to regulate the interactions between doctors and PI. However, there is an ongoing debate whether these were thoroughly implemented in practice and internalized by physicians. The objective of our study was to assess the attitudes and behaviors of trainees in psychiatry and child & adolescent psychiatry toward PI across Europe. Methodologically, a validated questionnaire with additional items was administered to1444 trainees in 20 European countries. The minimum response rate was set at 60%. We found a high variation across countries in number of interactions between trainees and PI representatives; Portugal and Turkey had the highest number of interactions. The majority (59.76%) agreed that interactions with PI representatives have an impact on physicians’ prescribing behavior; whereas only 29.26% and 19.79% agreed interactions with PI representatives and gifts from PI have impact on their own prescribing behavior, respectively. Most of the gifts were considered appropriate by the majority, except tickets to vacation spot and social dinner at a restaurant. Of the sample, 70.76% think they have not been given sufficient training regarding how to interact with PI representatives. Only less than 20% indicated they have guidelines at institutional or national level. In conclusion, there is substantial interaction between trainees and PI across countries. The majority feel inadequately trained regarding professional interaction with PI, and believes they are immune to the influence of PI.
• The European Federation of Psychiatric Trainees is an independent federation of psychiatric trainees associations. 37 Countries were represented at the annual Forum in 2011.
• A Child and Adolescent Psychiatry (CAP) Working Group meets at this annual forum to discuss issues of relevance to CAP trainees. At the 2009 meeting, the group reflected on difficulties in collecting data on training across Euro.
1. Ten item survey was was circulated to trainee representatives to the European Federation of Psychiatric Trainees who attended the annual Forum in 2009.
2. Following this pilot study, a much larger study was conducted from 2010–2011.
• EFPT survey: In 2009–2010 pilot survey - 27 countries responded.
• The EFPT CAP group expanded this in 2010–2011. This survey collected data from 34 countries, 28 of whom provided full data-sets in the following domains:
○Structure and organisation of training;
○Training quality and content; and
○Working conditions and recruitment.
○Statistical analysis was performed on the data to achieve overall rankings of CAP training quality.
• This symposium will look at developing national and international surveys. Results from two completed EFPT CAP studies and ongoing work presented. These studies add significantly to extant literature- it is clear that training across Europe is extremely variable.
• This symposium will also highlight current opportunities for European Trainees. International collaborations and opportunities for trainees will be explored, and we will consider the role of trainees in international organisations
EFPT - The European Federation of Psychiatric Trainees is an independent federation of psychiatric trainees associations and its function is to provide a forum in which trainees can learn about the diversity of the current training of psychiatrists in Europe.
EFPT consists of several working groups that focus on supporting different fields (e.g. psychotherapy, child and adolescent psychiatry etc) and carry out various projects. The aim of CAP working group is firstly to represent CAP trainees and develop common recommendations regarding training while furthering links with organisations such as UEMS. In recent years the group has also recognised the need to collect information in order to assess the quality level of training in european countries, to recognise differences and build upon positives. In 2010–2011 this focused on training standards around Europe. In 2011–2012 we focus on:
A. The field of psychotherapy. The CAP group recognises that family relationships play a major role in the formation of a child's personality. The survey is being conducted in conjunction with the Psychotherapy WG within EFPT; thus training in this area in both adult psychiatry and CAP will be compared. Initial results will be presented at this symposium.
B. We believe that awareness of mental illness in the childhood should be an important part of the education in medical faculties. Therefore, we are keen to ascertain what placement opportunities in CAP are currently offered to medical students around Europe. Gathering information on this isT is our second aim for the next year.
Despite evidence that the majority of injection drug users (IDU) are polysubstance users and tend to have extensive substance use histories at time of first injection, little is known about the patterns of substance use associated with injection initiation.
To determine how injection drug use was associated with specific patterns of multiple substance use. Both concurrent (any use during a defined time period) and simultaneous (same session) polysubstance use patterns were assessed.
IDU receiving treatment at a low-threshold methadone maintenance clinic in Halifax, Nova Scotia, Canada completed structured interviews regarding their substance use histories.
Injection coincided with: concurrent heavy alcohol use; increasing use of stimulants such as cocaine; and the introduction of misused prescription medications. During their most recent injection session, participants were significantly less likely to inject a stimulant, and were significantly more likely to identify an opioid as their primary drug of injection, when compared to injection initiation. Moreover, alcohol was more likely to be co-administered at time of first-ever injection, whereas prescription sedatives and crack cocaine were more likely to be co-administered during the most recent injection.
Initiation into injection tended to occur after an extensive and relatively consistent sequence of substance use. First ever and most recent injection drug use often occurred within a polysubstance context; however, the specific patterns of substance use changed with time. Findings suggest that specific patterns of multiple substance use may be appropriate targets for treatment and prevention of injection drug use.
Interactions between the pharmaceutical industry (PI) and psychiatrists have been under scrutiny recently, though there is little empirical evidence on the nature of the relationship and its intensity at psychiatry trainee level. We therefore studied the level of PI interactions and the underlying beliefs and attitudes in a large sample of European psychiatric trainees.
One thousand four hundred and forty-four psychiatric trainees in 20 European countries were assessed cross-sectionally, with a 62-item questionnaire.
The total number of PI interactions in the preceding two months varied between countries, with least interactions in The Netherlands (M (Mean) = 0.92, SD = 1.44, range = 0–12) and most in Portugal (M = 19.06, SD = 17.44, range = 0–100). Trainees were more likely to believe that PI interactions have no impact on their own prescribing behaviour than that of other physicians (M = 3.30, SD = 1.26 vs. M = 2.39, SD = 1.06 on a 5-point Likert scale: 1 “completely disagree” to 5 “completely agree”). Assigning an educational role to the pharmaceutical industry was associated with more interactions and higher gift value (IRR (incidence rate ratio) = 1.21, 95%CI = 1.12–1.30 and OR = 1.18, 95%CI = 1.02–1.37).
There are frequent interactions between European psychiatric trainees and the PI, with significant variation between countries. We identified several factors affecting this interaction, including attribution of an educational role to the PI. Creating alternative educational opportunities and specific training dedicated to PI interactions may therefore help to reduce the impact of the PI on psychiatric training.
This is the first European psychiatric exchange programme and it aims to promote an intercultural professional exchange and cooperation among psychiatric trainees across Europe, with a focus on individual experience.
To provide trainees with the opportunities to:
promote awareness of intercultural aspects of psychiatry
engage in clinical, and/or research, and/or teaching activities
become acquainted with different mental health systems
gain experience of different illness manifestations and treatment options
experience a different training programme
socialise with peer group, promote networking and discuss coping strategies regarding work life balance
The programme was developed by the exchange working group of the EFPT in 2011 and it offers 2-6 weeks in observational placements across Europe in diverse areas.
Feedback from pilot phase (January-July 2012) has shown excellent overall satisfaction of participants in the project. In the 2nd phase (August-December 2012) the programme has expanded offering more observational placements in 8 countries such as: Croatia, Denmark, France, Italy, Portugal, Slovenia, Spain and UK. In the 3rd phase (January-July 2013) it expanded further to include Ireland, Netherlands and Romania in a total of 11 hosting countries. Placements are offered in many subspecialties such as: psychotherapy, emergency psychiatry, child and adolescent psychiatry, eating disorders, family therapy, liaison psychiatry and psychosomatics, drug addictions, learning disabilities, forensic psychiatry and old age psychiatry.
We hope that the diversity of placements offered by this innovative programme will constitute a new approach to the improvement of psychiatric training and practice across Europe.
To explore associations of whole grain and cereal fibre intake to CVD risk factors in Australian adults.
Cross-sectional analysis. Intakes of whole grain and cereal fibre were examined in association to BMI, waist circumference (WC), blood pressure (BP), serum lipid concentrations, C-reactive protein, systolic BP, fasting glucose and HbA1c.
Australian Health Survey 2011–2013.
A population-representative sample of 7665 participants over 18 years old.
Highest whole grain consumers (T3) had lower BMI (T0 26·8 kg/m2, T3 26·0 kg/m2, P < 0·0001) and WC (T0 92·2 cm, T3 90·0 cm, P = 0·0005) compared with non-consumers (T0), although only WC remained significant after adjusting for dietary and lifestyle factors, including cereal fibre intake (P = 0·03). Whole grain intake was marginally inversely associated with fasting glucose (P = 0·048) and HbA1c (P = 0·03) after adjusting for dietary and lifestyle factors, including cereal fibre intake. Cereal fibre intake was inversely associated with BMI (P < 0·0001) and WC (P < 0·0008) and tended to be inversely associated with total cholesterol, LDL-cholesterol and apo-B concentrations, although associations were attenuated after further adjusting for BMI and lipid-lowering medication use.
The extent to which cereal fibre is responsible for the CVD-protective associations of whole grains may vary depending on the mediators involved. Longer-term intervention studies directly comparing whole grain and non-whole grain diets of similar cereal fibre contents (such as through the use of bran or added-fibre refined grain products) are needed to confirm independent effects.