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Caring for a child with intellectual disabilities can be a very rewarding but demanding experience. Research in this area has primarily focused on mothers, with relatively little attention given to the mental health of fathers.
The purpose of this review was to summarise the evidence related to the mental health of fathers compared with mothers, and with fathers in the general population.
A meta-analysis was undertaken of all studies published by 1 July 2018 in Medline, PsycINFO, CINAHL and EMBASE, using terms on intellectual disabilities, mental health and father carers. Papers were selected based on pre-defined inclusion and exclusion criteria.
Of 5544 results, 20 studies met the inclusion criteria and 12 had appropriate data for meta-analysis. For comparisons of fathers with mothers, mothers were significantly more likely to have poor general mental health and well-being (standardised mean difference (SMD) −0.38, 95% CI −0.56 to −0.20), as well as higher levels of depression (SMD, −0.46; 95% CI −0.68 to −0.24), stress (SMD, −0.32; 95% CI −0.46 to −0.19) and anxiety (SMD, −0.30; 95% CI −0.50 to −0.10).
There is a significant difference between the mental health of father and mother carers, with fathers less likely to exhibit poor mental health. However, this is based on a small number of studies. More data is needed to determine whether the general mental health and anxiety of father carers of a child with intellectual disabilities differs from fathers in the general population.
One of the critical components of energy savings in buildings is thermal insulation, especially for windows in cold climates. The conventional approach mainly relies on a double-pane design. In this study, a new concept of “Green Window” has been designed for single-pane applications that lower the U-factor. The “Green Window” is structurally and simply composed of a thin film window coating of chlorophyll that exhibits pronounced photothermal effect, while remaining highly transparent. We demonstrate a new concept in “thermal insulation” via optical means instead of solely through thermal insulators or spectral selectivity. This concept lifts the dependence on insulating materials making single-pane window highly possible.
Although childhood adversity is a potent determinant of psychopathology, relatively little is known about how the characteristics of adversity exposure, including its developmental timing or duration, influence subsequent mental health outcomes. This study compared three models from life course theory (recency, accumulation, sensitive period) to determine which one(s) best explained this relationship.
Prospective data came from the Avon Longitudinal Study of Parents and Children (n = 7476). Four adversities commonly linked to psychopathology (caregiver physical/emotional abuse; sexual/physical abuse; financial stress; parent legal problems) were measured repeatedly from birth to age 8. Using a statistical modeling approach grounded in least angle regression, we determined the theoretical model(s) explaining the most variability (r2) in psychopathology symptoms measured at age 8 using the Strengths and Difficulties Questionnaire and evaluated the magnitude of each association.
Recency was the best fitting theoretical model for the effect of physical/sexual abuse (girls r2 = 2.35%; boys r2 = 1.68%). Both recency (girls r2 = 1.55%) and accumulation (boys r2 = 1.71%) were the best fitting models for caregiver physical/emotional abuse. Sensitive period models were chosen alone (parent legal problems in boys r2 = 0.29%) and with accumulation (financial stress in girls r2 = 3.08%) more rarely. Substantial effect sizes were observed (standardized mean differences = 0.22–1.18).
Child psychopathology symptoms are primarily explained by recency and accumulation models. Evidence for sensitive periods did not emerge strongly in these data. These findings underscore the need to measure the characteristics of adversity, which can aid in understanding disease mechanisms and determining how best to reduce the consequences of exposure to adversity.
Relative poverty, a concept developed by left-wing social scientists, categorises as ‘poor’ those who fall seriously behind normal nationwide material standards. This article argues that the widespread view that the word ‘poverty’ means ‘relative poverty’, which in left-dominated social policy academia often extends to implying that those who do not define poverty this way are necessarily misguided, has led to an incomplete portrayal of poorer British people's lived experience. The article examines published empirical work, before presenting findings from British Social Attitudes surveys and interviews with forty unemployed Jobseeker's Allowance claimants and thirty employed people. Both the existing and new findings exposed aspects of public attitudes and experience which resonate with unanswered academic criticisms of defining poverty as relative poverty. These public contributions have tended to be glossed over or treated dismissively by social policy authors, despite them attaching importance to Left-friendly aspects of poorer people's experience and attitudes.
This article presents results from the first 3 rounds of an international intercomparison of measurements of Δ14CO2 in liter-scale samples of whole air by groups using accelerator mass spectrometry (AMS). The ultimate goal of the intercomparison is to allow the merging of Δ14CO2 data from different groups, with the confidence that differences in the data are geophysical gradients and not artifacts of calibration. Eight groups have participated in at least 1 round of the intercomparison, which has so far included 3 rounds of air distribution between 2007 and 2010. The comparison is intended to be ongoing, so that: a) the community obtains a regular assessment of differences between laboratories; and b) individual laboratories can begin to assess the long-term repeatability of their measurements of the same source air. Air used in the intercomparison was compressed into 2 high-pressure cylinders in 2005 and 2006 at Niwot Ridge, Colorado (USA), with one of the tanks “spiked” with fossil CO2, so that the 2 tanks span the range of Δ14CO2 typically encountered when measuring air from both remote background locations and polluted urban ones. Three groups show interlaboratory comparability within l% for ambient level Δ14CO2. For high CO2/low Δ14CO2 air, 4 laboratories showed comparability within 2%. This approaches the goals set out by the World Meteorological Organization (WMO) CO2 Measurements Experts Group in 2005. One important observation is that single-sample precisions typically reported by the AMS community cannot always explain the observed differences within and between laboratories. This emphasizes the need to use long-term repeatability as a metric for measurement precision, especially in the context of long-term atmospheric monitoring.
This is a study of the growth and decline of cities for the purpose of identifying those events in which they significantly increased in size. Significant changes in the scale of cities are important for understanding the long-term trend toward more complex and hierarchical human societies. We report the results of an inventory of cycles, upsweeps, and collapses of settlements in five separate interpolity systems. Upsweeps are instances in which the largest settlement in a world system significantly increases in size. Collapses occur when the size of the largest settlement greatly decreases and stays down for a significant period of time rather than rebounding. We use regional interpolity systems (world systems) rather than single polities or settlements as our unit of analysis. Because the accurate designation of sweeps requires interval scale measures, we are limited to those regions and time periods for which quantitative estimates of largest settlement sizes are regularly available. We find a total of 18 upsweeps and five downsweeps, and only two instances of prolonged systemwide settlement collapse. We also investigate whether or not the rate of cycles has increased over the long run, and we find that cycles of city growth and decline have not accelerated. We also find a greater rate of urban cycles in the Western (Central) System than in the East Asian System, which supports the usual notion that the Western city system was less stable than the Eastern city system.
Research suggests that the way in which cognitive therapy is delivered is an important factor in determining outcomes. We test the hypotheses in which the development of a shared problem list, use of case formulation, homework tasks and active intervention strategies will act as process variables.
Presence of these components during therapy is taken from therapist notes. The direct and indirect effect of the intervention is estimated by an instrumental variable analysis.
A significant decrease in the symptom score for case formulation (coefficient =–23, 95% CI –44 to –1.7, P = 0.036) and homework (coefficient =–0.26, 95% CI –0.51 to –0.001, P = 0.049) is found. Improvement with the inclusion of active change strategies is of borderline significance (coefficient =–0.23, 95% CI –0.47 to 0.005, P = 0.056).
There is a greater treatment effect if formulation and homework are involved in therapy. However, high correlation between components means that these may be indicators of overall treatment fidelity.
The vexed and ongoing issue of poor educational outcomes for Indigenous students in the Northern Territory continues despite years of successive programs and policies. Much of the debate has been on funding and pedagogy, in particular the merits or otherwise of bi-lingual teaching. Largely omitted from discussions, although well known by teachers and schools in remote areas to be an issue, are high rates of in-term student mobility. Such “unexpected” moves are thought to affect the capacity for students to achieve benchmark outcomes, for teachers to deliver these and for schools to administer their students within the allocated systems and budgets. Up to now teachers and schools have relied on anecdotes to engage in dialogue around the impacts of mobility. This is because adequate conceptualisations for aggregating, depicting and reporting on the size and nature of in-term mobility were not available. This paper documents several years of work into producing these outcomes. Three measures are conceptualised and outlined in this paper which will be of interest to teachers, schools and educational administrators in all jurisdictions where services are delivered in a remote setting. The results clearly demonstrate the high churn of Indigenous students within terms, especially in remote areas of the Northern Territory. The findings from this study can be applied to inform funding and policy making and as a basis for further research to document the impacts for teachers and schools.
The Work Programme's use of severe social security benefit sanctions reflects British coalition ministers’ belief that many people on out-of-work benefits do not want a job. While a substantial empirical literature has repeatedly demonstrated that in fact unemployed benefit claimants possess the same work values as the employed and that the vast majority want paid work, it has ignored some conservative authors’ pleas to consider the views and experiences of people who work with the unemployed. Forty employees of agencies contracted to help unemployed people into employment were interviewed in summer 2011. Respondents had spent an estimated combined total of 147,000 hours in the presence of people who have claimed Jobseeker's Allowance (JSA) for over six months. Most said that between a quarter and half of their present clients did not want employment. This finding does not contradict existing research, given that most JSA claimants re-enter employment within six months. However, all forty agreed that many others remained unemployed because they were choosy in the jobs they were willing to undertake, and, most strikingly, respondents overwhelmingly endorsed the view that a ‘dependency culture’ exists in households and neighbourhoods that have experienced joblessness for several generations.
Fruit and vegetable consumption is associated with improved health outcomes, yet there is limited understanding of the impact of cost and accessibility on fruit and vegetable intake in rural settings. This study examines the relationship between the consumption of fruits and vegetables and their cost and accessibility among blacks and non-Hispanic whites in a rural area. Individual characteristics from a 2006 mail survey (n = 1,510) were combined with store locations and price information from a 2006 ground-truthed census of retail outlets. The mail survey covered seven counties in central Texas with 38 supermarkets/grocery stores. Blacks tended to live closer to a supermarket or grocery store, but they were only slightly more likely than whites to consume two or more servings of fruit daily and much less likely to consume three or more servings of vegetables. Multivariate probit regression analysis revealed that neither access nor cost was related to fruit or vegetable consumption among white respondents. Among blacks, cost was also not associated with consumption. In contrast to whites, however, each additional mile was associated with a three percentage point decline in the probability of consuming two or more servings of fruit daily and a 1.8 percentage point decline in the probability of consuming three or more vegetable servings.
First FRCR Anatomy: Questions and Answers provides eight test papers modelled on the exam format of the Royal College of Radiologists' anatomy module. Written by a team of consultant and trainee radiologists, the practice questions and answers will give you the advantage you need to succeed and stand out from the average trainee. The questions include images from all modalities – CT, MRI, ultrasound, plain film, screening and angiography, closely correlating with the images you are likely to see both in the exam and in day-to-day practice. Expanded clinical answers also distill clinical radiological knowledge accrued over many years of clinical practice, making this much more than a revision aid. First FRCR Anatomy: Questions and Answers covers the full breadth of curriculum topics including MSK, cardiac, thoracic, genitourinary, gastrointestinal, vascular, neuro and pediatric imaging. An essential resource for all First FRCR candidates.
Posterior sub-talar joint (PSTJ). The PSTJ is a synovial joint formed by the articulation of the posterior articular facets of the talus and calcaneum. Intra-articular extension into the PSTJ is often seen in comminuted calcaneal compression fractures and represents an important factor in the surgical classification of these injuries.
Cuboid. The cuboid possesses a proximal articular surface that only articulates with the calcaneum. Distally the cuboid articulates with the fourth and fifth metatarsals.
Neck of the talus. The talar neck is an important review area when evaluating ankle radiographs and CT in the setting of trauma. Missed talar neck fractures can result in avascular necrosis of the talar dome due to its blood supply being derived from vessels that enter the talar head and travel proximally within the neck.
The sinus tarsi. This is a fatty space beneath the talar neck and above the calcaneal body. The sinus tarsi also contains the cervical and interosseous ligaments along with traversing nerves and vessels. Inflammation and cyst formation in this space following trauma may produce a painful ‘sinus-tarsi syndrome’.
Os trigonum. This is present in 10% of individuals and when present, is bilateral in 50%. It may be present as a separate ossicle or be partly fused with the posterior talar process forming a synchrondrosis. The os trigonum may produce repetitive soft tissue impingment in the ankle due to repetitive plantar-flexion resulting in a painful ‘os-trigonum syndrome’.
Transverse ultrasound through stomach pylorus and upper abdomen
Lesser trochanter of the right femur. The iliopsoas tendon attaches here. This is a powerful flexor of the hip.
Greater trochanter of the right femur. Gluteus medius and gluteus minimis attach here. These tendons act to perform hip abduction and lateral rotation. They can produce avulsion fractures of the greater trochanter in trauma.
Left L5 transverse process. The ilio-lumbar ligament attaches here. Traction of this ligament in pelvic trauma can cause an avulsion fracture of the transverse process. It also acts as an anatomical landmark on MRI for identifying the L5 vertebral body.
Pubic symphysis. It is a secondary cartilaginous joint.
Left inferior pubic ramus. Adductor magnus and adductor brevis attach here acting to adduct the hip.
Axial T2-weighted lumbar spine through L5
Left L5 nerve. At the level of the L5/S1 disc, the L5 nerve has already left the neural exit foramen. It may become compromised by a far lateral L5 disc herniation in this position.
Nucleus pulposus of L5/S1 disc. This soft central component of the disc is surrounded by the tough outer annulus fibrosus. Annular defects result in herniation of the nucleus pulposus referred to as protrusions or extrusions, based upon their morphology. On T2-weighted images the nucleus pulposus is of high signal and the annulus fibrosus is of low signal intensity.
Left lamina of L5 vertebra. Each lamina fuses in the midline to form the spinous process. The lamina is partly or completely resected (laminectomy) during lumbar disc surgery to facilitate access to the disc.
Right psoas major muscle. This is a powerful hip flexor. In the clinical setting of lumbar discitis it is common to see infection tracking from the disc space into the psoas muscle to form a psoas abscess.
Popliteus tendon. This point represents the popliteal groove or sulcus within which the popliteus tendon inserts. The popliteus tendon is an important structure that contributes to stability of the postero-lateral corner of the knee.
Styloid process of the fibular head. Biceps femoris, a powerful hamstring muscle, attaches here along with the fibular collateral ligament and the arcuate ligament complex. The fibular styloid process can be avulsed during high energy trauma to the postero-lateral corner of the knee producing an ‘arcuate sign’ on radiographs.
Medial collateral ligament (MCL). The MCL is an important medial stabilizer of the knee, resisting valgus stress. A bony avulsion of the proximal MCL attachment may produce a non-united fragment called a Pellegrini–Stieda lesion, visible on AP radiographs.
Medial tibial spine. The medial tibial spine bears the attachment of the medial meniscal roots along with the footprint of the antero-medial bundle of the anterior cruciate ligament.
Bipartite patella. A bipartite patella is an unfused secondary ossification centre on the supero-lateral corner of the patella. These must not be mistaken for acute fractures, but may become symptomatic if the synchondrosis between the two bone fragments is disrupted following direct trauma.
Main submandibular duct. This is also known as Wharton's duct, and conveys mixed mucinous and serous secretions, which are more prone to form opaque calculi.
Intraglandular duct. On ultrasound scan examination, intraglandular ducts are visualized as small linear hypoechoic stripes.
Hyoid bone. This does not articulate with any other bone, and is held in position by the thyroid ligaments. It is highly mobile, with mobility provided by a number of muscles and ligaments. It develops from the second and third pharyngeal arches.
Condylar process of the mandible. The lateral extremity of the condyle is a small tubercle for the attachment of the temporomandibular ligament.
Coronoid process of the mandible. This is a thin triangular eminence, whose lateral surface affords insertion to the temporalis and masseter muscles.