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Healthcare workers (HCWs) have a theoretically increased risk of contracting severe acute respiratory coronavirus virus 2 (SARS-CoV-2) given their occupational exposure. We tested 2,167 HCWs in a London Acute Integrated Care Organisation for antibodies to SARS-CoV-2 in May and June 2020 to evaluate seroprevalence. We found a seropositivity rate of 31.6% among HCWs.
Despite the scientific evidence, most families of people with schizophrenia in Europe never receive a carer education programme. We evaluated whether a carer education course delivered by telepsychiatry was as effective as a carer education course delivered in situ.
We delivered the carer education course for schizophrenia simultaneously to a carers group in rural north west Ireland (remote) via three ISDN lines and live to a carers group in a city (host). We compared knowledge gains using the Knowledge Questionnaire before and after each course.
Fifty-six carers of people with schizophrenia participated in the trial. At baseline, participants at the remote and host centers did not differ in terms of knowledge about schizophrenia. After the course, carers at both centers improved significantly and the knowledge gains between groups were equivalent at 6 weeks.
Telepsychiatry can deliver effective carer education programmes about schizophrenia and may provide one solution to bridging the chasm between scientific evidence and clinical reality.
The early fetal environment during pregnancy is extremely important and research indicates that weight at birth can have crucial impacts for the individual's health later in life. With rates of childhood obesity estimated to be as high as 21% in some European countries, it is vital that early risk factors are identified so that interventions can be developed. We aimed to investigate if children born macrosomic (birth weight > 4kg) remained larger than normal birth weight babies up to 5 years of age.
Materials and Methods:
This is a longitudinal follow-up of 387 five-year-old children (53% born with macrosomia, 47% normal birth weight) born into the ROLO randomised control trial in the National Maternity Hospital, Dublin (ISRCTN54392969). Birth weight was previously recorded then at 6 months, 2 years, and 5 years of age child height, weight, anthropometric and skinfold measurements were collected. Body Mass Index (kg/m2) and centiles were calculated. Student t-tests and Mann-Whitney U tests were used to compare the two groups with multiple linear regression modelling to control for confounders.
Children with a birth weight > 4 kg had consistently higher weights, lengths, and BMI centiles, along with increased head and chest circumferences, compared to normal birth weight children from 6 months up to 5 years of age (p < 0.05). After controlling for child sex, intervention group, smoking during pregnancy, maternal education status, and maternal BMI, children with macrosomia were 0.61 kg heavier than non-macrosomic infants at 5 years of age (95% CI: 0.04–1.18, p < 0.05).
Children born with a high birth weight remain heavier and larger into childhood. These individuals are at a higher risk of obesity which highlights the need for monitoring and potential interventions, both during pregnancy and in infancy, to curb the current childhood obesity crisis.
Infant protein intake has been associated with child growth, however, research on maternal protein intake during pregnancy is limited. Insulin-like growth factors (IGF) play a role in early fetal development and maternal protein intake may influence child body composition via IGF-1. The aim of this study was to investigate the association of maternal protein intake throughout pregnancy on cord blood IGF-1 and child body composition from birth to 5 years of age. Analysis was carried out on 570 mother–child dyads from the Randomised cOntrol trial of LOw glycaemic index diet study. Protein intake was recorded using 3-d food diaries in each trimester of pregnancy and protein intake per kg of maternal weight (g/d per kg) was calculated. Cord blood IGF-1 was measured at birth. Infant anthropometry was measured at birth, 6 months, 2 and 5 years of age. Mixed modelling, linear regression, and mediation analysis were carried out. Birth weight centiles were positively associated with early-pregnancy protein intake (g/d per kg), while weight centiles from 6 months to 5 years were negatively associated (B=−21·6, P<0·05). These associations were not mediated by IGF-1. Our findings suggest that high protein intake in early-pregnancy may exert an in utero effect on offspring body composition with a higher weight initially at birth but slower growth rates into childhood. Further research is needed to elucidate the exact mechanisms by which dietary protein modulates fetal growth.
Introduction: In the past few years, there has been an increase in awareness of the challenge of managing work related stress in EMS. Extant research has liked different types of chronic and critical incident stress to stress reactions like posttraumatic stress. However, there is no tool to capture the transactional stresses which are associated with the day to day provision of service (e.g., dealing with offload delays or mandatory overtime) and interacting with allied professions (e.g., emergency department staff) or allied agencies (e.g., law enforcement). The purpose of this study was to develop and validate a measure which captured transactional stresses in paramedics Methods: An online survey was conducted with ten Canadian Paramedic Services with a 40.5% response rate (n= 717). Factor analysis was used to identify variation in responses related to the latent factor of transactional stress. The scale was validated using both exploratory and confirmatory factor analyses. Results: The sample of transactional stress questions was split to allow for multiple analyses (EFA n=360/ CFA n=357). In the exploratory factor analysis, principal axis factoring with an oblique rotation revealed a two-factor, twelve item solution, (KMO=.832, x2=1440.19, df=66, p<.001). Confirmatory factor analysis also endorsed a two factor, 12 item solution, (x2 =130.39, df=51, p<.001, CFI=.95, TLI= .93, RMSEA= .07, SRMR= .06). Results supported two groups of six-item factors that captured transactional stress in the provision of service. The factors, clearly aligned with transactional stress issues internal to the ambulance and transactional stress relationships external to the ambulance. Both subscales demonstrated good internal reliability (= .843/ =.768) and were correlated (p.01) with a convergent validity measure. Conclusion: This study successfully validated a two-factor scale which captures stress associated with the day to day provision of EMS and the interaction with allied professions. The development of this measure of transactional stresses further expands the potential that paramedics, Paramedic Services, employers, and prehospital physicians may understand the dynamics that influence provider health and safety. As a result, there may be greater opportunities to intervene holistically to improve paramedic health and well-being.
A new stream of research proposes how people can increase their income in retirement by pooling their mortality risk. How one of these mortality risk-sharing rules could be implemented in practice, as part of a retirement income scheme, is considered. A potential advantage of the scheme is that a retiree’s housing wealth can be monetised to provide an income stream. This would mean that retirees can continue living in their home, without needing to downsize. It may be most attractive to the millions of single pensioners, particularly those who are “asset-rich and cash-poor”. Other types of assets that could be included and how to mitigate selection risks are assessed. A way of smoothing the raw mortality credits in order to make the scheme more appealing to potential members is proposed. An illustrative premium calculation suggests that the cost of the smoothing is very small compared to the potential attractiveness of an enhanced, smoothed income.
Common to all previous studies assessing the cost of adverse selection associated with genetics has been the assumption of an established market, i.e., the adverse selectors have been buying insurance at that rate for such a period that premiums have already absorbed it. Their analyses involve calculating the percentage difference between premiums in a market with adverse selection and one without adverse selection. They can shed no light on how the premiums would get to this stage over time and what losses might be incurred in the process. We take the modelling further by outlining a multiple state Markov model for a start-up market of long-term care insurance. With this model, we explicitly show the progression of adverse selection costs using the development of information that an insurer would gain from analysing the claims history of its existing business, to reprice premiums for new business. To overcome the complication of insurance benefit amounts, which depend on the value of previous benefit payments, we develop a simulation approach of estimating the expected present values of insurance benefits and premium payments. In applying our modelling to a UK setting, we find genetic testing of the apolipoprotein E gene (whose variants can cause a high risk of developing dementia) to be of a relatively small impact compared with our hypothetical state of intermediate dementia progression. Furthermore, we find that the government’s cap on care costs has little effect on adverse selection costs as it benefits only a small proportion of people.
Hospice patients often struggle with loss of meaning, while many experience meaningful dreams. The purpose of this study was to conduct a preliminary exploration into the process and therapeutic outcomes of meaning-centered dream work with hospice patients.
A meaning-centered variation of the cognitive–experiential model of dream work (Hill, 1996; 2004) was tested with participants. This variation was influenced by the tenets of meaning-centered psychotherapy (Breitbart et al., 2012). A total of 12 dream-work sessions were conducted with 7 hospice patients (5 women), and session transcripts were analyzed using the consensual qualitative research (CQR) method (Hill, 2012). Participants also completed measures of gains from dream interpretation in terms of existential well-being and quality of life.
Participants' dreams generally featured familiar settings and living family and friends. Reported images from dreams were usually connected to feelings, relationships, and the concerns of waking life. Participants typically interpreted their dreams as meaning that they needed to change their way of thinking, address legacy concerns, or complete unfinished business. Generally, participants developed and implemented action plans based on these interpretations, despite their physical limitations. Participants described dream-work sessions as meaningful, comforting, and helpful. High scores on a measure of gains from dream interpretation were reported, consistent with qualitative findings. No adverse effects were reported or indicated by assessments.
Significance of Results:
Our results provided initial support for the feasibility and helpfulness of dream work in this population. Implications for counseling with the dying and directions for future research were also explored.
The MIAMI* facility at the University of Huddersfield is one of a number of facilities worldwide that permit the ion irradiation of thin foils in-situ in a transmission electron microscope. MIAMI has been developed with a particular focus on enabling the in-situ implantation of helium and hydrogen into thin electron transparent foils, necessitating ion energies in the range 1 – 10 keV. In addition, however, ions of a variety of species can be provided at energies of up to 100 keV (for singly charged ions), enabling studies to focus on the build up of radiation damage in the absence or presence of implanted gas.
This paper reports on a number of ongoing studies being carried out at MIAMI, and also at JANNuS (Orsay, France) and the IVEM / Ion Accelerator Facility (Argonne National Lab, US). This includes recent work on He bubbles in SiC and Cu; the former work concerned with modification to bubble populations by ion and electron beams and the latter project concerned with the formation of bubble super-lattices in metals.
A study is also presented consisting of experiments aimed at shedding light on the origins of the dimensional changes known to occur in nuclear graphite under irradiation with either neutrons or ions. Single crystal graphite foils have been irradiated with 60 keV Xe ions in order to create a non-uniform damage profile throughout the foil thickness. This gives rise to varying basal-plane contraction throughout the foil resulting in almost macroscopic (micron scale) deformation of the graphite. These observations are presented and discussed with a view to reconciling them with current understanding of point defect behavior in graphite.
*Microscope and Ion Accelerator for Materials Investigations
One of the central results in Einstein’s theory of Brownian motion is that the mean
square displacement of a randomly moving Brownian particle scales linearly with time. Over
the past few decades sophisticated experiments and data collection in numerous biological,
physical and financial systems have revealed anomalous sub-diffusion in which the mean
square displacement grows slower than linearly with time. A major theoretical challenge
has been to derive the appropriate evolution equation for the probability density function
of sub-diffusion taking into account further complications from force fields and
reactions. Here we present a derivation of the generalised master equation for an ensemble
of particles undergoing reactions whilst being subject to an external force field. From
this general equation we show reductions to a range of well known special cases, including
the fractional reaction diffusion equation and the fractional Fokker-Planck equation.
We use economic indicators to improve the prediction of the number of incurred but not recorded disability insurance claims, assuming that there is a link between the number of claims and the chosen economic indicators. We propose a Bayesian model where we model the claims development in three directions: along incurred periods, recording lag periods and calendar periods. A stochastic model of the economic indicators is incorporated into the calendar period development direction. Thus we allow for the impact of the economic environment on the number of claims. Applying the proposed model to data, we illustrate how the inclusion of economic indicators affects the prediction of the number of incurred but not recorded disability claims.
Adaptation, speciation and extinction
A. Donnelly, Trinity College Dublin, Ireland,
A. Caffarra, Istituto Agrario San Michele all'Adige, Italy,
E. Diskin, Trinity College Dublin, Ireland,
C. T. Kelleher, National Botanic Gardens, Glasnevin, Dublin, Ireland,
A. Pletsers, Trinity College Dublin, Ireland,
H. Proctor, Trinity College Dublin, Ireland,
R. Stirnemann, Trinity College Dublin, Ireland,
M. B. Jones, Trinity College Dublin, Ireland,
J. O'Halloran, University College Cork, Ireland,
B. F. O'Neill, Trinity College Dublin, Ireland,
J. Peñuelas, Campus Universitat Autònoma de Barcelona, Spain,
T. Sparks, Technische Universität München, Germany and Institute of Zoology, Poznań University of Life Sciences, University of Cambridge, UK
The impact of climate change, in particular increasing spring temperatures, on life-cycle events of plants and animals has gained scientific attention in recent years. Leafing of trees, appearance and abundance of insects, and migration of birds, across a range of species and countries, have been cited as phenotrends that are advancing in response to warmer spring temperatures. The ability of organisms to acclimate to variations in environmental conditions is known as phenotypic plasticity. Plasticity allows organisms to time developmental stages to coincide with optimum availability of environmental resources. There may, however, come a time when the limit of this plasticity is reached and the species needs to adapt genetically to survive. Here we discuss evidence of the impact of climate warming on plant, insect and bird phenology through examination of: (1) phenotypic plasticity in (a) bud burst in trees, (b) appearance of insects and (c) migration of birds; and (2) genetic adaptation in (a) gene expression during bud burst in trees, (b) the timing of occurrence of phenological events in insects and (c) arrival and breeding times of migratory birds. Finally, we summarise the potential consequences of future climatic changes for plant, insect and bird phenology.
The recent resurgence of interest in phenology (the timing of recurring life-cycle events in plants and animals) has stemmed from research on the impact of climate change, in particular, global warming.
The aim of this study was to investigate the impact of cochlear implant electrode insertion on middle-ear low frequency function in humans.
Preservation of residual low frequency hearing with addition of electrical speech processing can improve the speech perception abilities and hearing in noise of cochlear implant users. Preservation of low frequency hearing requires an intact middle-ear conductive mechanism in addition to intact inner-ear mechanisms. Little is known about the effect of a cochlear implant electrode on middle-ear function.
Stapes displacement was measured in seven patients undergoing cochlear implantation. Measurements were carried out intra-operatively before and after electrode insertion. Each patient acted as his or her own control. Sound was delivered into the external auditory canal via a speaker and calibrated via a probe microphone. The speaker and probe microphone were integrated into an individually custom-made ear mould. Ossicular displacement in response to a multisine stimulus at 80 dB SPL was measured at the incudostapedial joint via the posterior tympanotomy, using an operating microscope mounted laser Doppler vibrometry system.
Insertion of a cochlear implant electrode into the scala tympani had a variable effect on stapes displacement. In three patients, there was little change in stapes displacement following electrode insertion. In two patients, there was a significant increase, while in a further two there was a significant reduction in stapes displacement. This variability may reflect alteration of cochlear impedance, possibly due to differing loss of perilymph associated with the electrode insertion.
Insertion of a cochlear implant electrode produces a change in stapes displacement at low frequencies, which may have an effect on residual low frequency hearing thresholds.
The hypothesis that the parasite Toxoplasma gondii manipulates the behaviour of its intermediate rat host in order to increase its chance of being predated specifically by its feline definitive host, rather than a non-definitive host predator species, was tested. The impact of a range of therapeutic drugs, previously demonstrated to be effective in preventing the development of T. gondii-associated behavioural and cognitive alterations in rats, on definitive-host predator specificity was also tested. Using a Y-shaped maze design, we demonstrated that T. gondii-associated behavioural changes, apparently aimed to increase predation rate, do appear to be specific to that of the feline definitive host – there were significant and consistent differences between the (untreated) infected and uninfected rats groups where T. gondii-infected rats tended to choose the definitive host feline-predator-associated maze arm and nest-box significantly more often than a maze arm or nest-box treated with non-definitive host predator (mink) odour. Drug treatment of infected rats prevented any such host-specificity from being displayed. We discuss our results in terms of their potential implications both for T. gondii epidemiology and the evolution of parasite-altered behaviour.
The Randomized Badger Culling Trial (RBCT) began in 1998 to determine the impact of badger culling in controlling bovine tuberculosis in cattle. A total of 1166 badgers (14% of total) proactively culled during the RBCT were found to be tuberculous, offering a unique opportunity to study the pathology caused by Mycobacterium bovis in a large sample of badgers. Of these, 39% of adults (~6% of all adults culled) had visible lesions (detectable at necropsy) of bovine tuberculosis; cubs had a lower prevalence of infection (9%) but a higher percentage of tuberculous cubs (55·5%) had visible lesions. Only ~1% of adult badgers had extensive, severe pathology. Tuberculous badgers with recorded bite wounds (~5%) had a higher prevalence of visible lesions and a different distribution of lesions, suggesting transmission via bite wounds. However, the predominance of lesions in the respiratory tract indicates that most transmission occurs by the respiratory route.
Using CHIRP subbottom profiling across the Chukchi shelf, offshore NW Alaska, we observed a large incised valley that measures tens of kilometers in width. The valley appears to have been repeatedly excavated during sea level lowering; however, the two most recent incisions appear to have been downcut during the last sea level rise, suggesting an increase in the volume of discharge. Modern drainage from the northwestern Alaskan margin is dominated by small, low-discharge rivers that do not appear to be large enough to have carved the offshore drainage. The renewed downcutting and incision during the deglaciation and consequent base level rise implies there must have been an additional source of discharge. Paleoprecipitation during deglaciation is predicted to be at least 10% less than modern precipitation and thus cannot account for the higher discharge to the shelf. Glacial meltwater is the most likely source for the increased discharge.
The relationship between children's anxiety and cognitive biases
was examined in two tasks. A group of 50 children aged 10 to 11 years
(mean = 11 years, SD = 3.71 months) was given two tasks. The
first tested children's selective attention (SA) to threat in an
emotional Stroop task. The second explored facial processing biases using
morphed angry-neutral and happy-neutral emotional expressions that varied
in intensity. Faces with varying levels of emotion (25% emotion–75%
neutral, 50% emotion–50% neutral, 100% emotion–0% neutral
[prototype] and 150% emotion–0% neutral
[caricature]) were judged as being angry or happy. Results
support previous work highlighting a link between anxiety and SA to
threat. In addition, increased anxiety in late childhood is
associated with decreased ability to discriminate facial
expression. Finally, lack of discrimination in the emotional expression
task was related to lack of inhibition to threat in the Stroop task.