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We introduce a new modelling framework to explain socio-economic differences in mortality in terms of an affluence index that combines information on individual wealth and income. The model is illustrated using data on older Danish males over the period 1985–2012 reported in the Statistics Denmark national register database. The model fits the historical mortality data well, captures their key features, generates smoothed death rates that allow us to work with a larger number of sub-groups than has previously been considered feasible, and has plausible projection properties.
Crisis resolution teams (CRTs) offer brief, intensive home treatment for people experiencing mental health crisis. CRT implementation is highly variable; positive trial outcomes have not been reproduced in scaled-up CRT care.
To evaluate a 1-year programme to improve CRTs’ model fidelity in a non-masked, cluster-randomised trial (part of the Crisis team Optimisation and RElapse prevention (CORE) research programme, trial registration number: ISRCTN47185233).
Fifteen CRTs in England received an intervention, informed by the US Implementing Evidence-Based Practice project, involving support from a CRT facilitator, online implementation resources and regular team fidelity reviews. Ten control CRTs received no additional support. The primary outcome was patient satisfaction, measured by the Client Satisfaction Questionnaire (CSQ-8), completed by 15 patients per team at CRT discharge (n = 375). Secondary outcomes: CRT model fidelity, continuity of care, staff well-being, in-patient admissions and bed use and CRT readmissions were also evaluated.
All CRTs were retained in the trial. Median follow-up CSQ-8 score was 28 in each group: the adjusted average in the intervention group was higher than in the control group by 0.97 (95% CI −1.02 to 2.97) but this was not significant (P = 0.34). There were fewer in-patient admissions, lower in-patient bed use and better staff psychological health in intervention teams. Model fidelity rose in most intervention teams and was significantly higher than in control teams at follow-up. There were no significant effects for other outcomes.
The CRT service improvement programme did not achieve its primary aim of improving patient satisfaction. It showed some promise in improving CRT model fidelity and reducing acute in-patient admissions.
Weed competition, especially within the crop row, limits the productivity and profitability of organic crop production. Abrasive weeding, a mechanical alternative to hand weeding, uses air-propelled grits to control small weed seedlings growing within the crop row. Recent research has demonstrated the successful use of abrasive weeding to reduce weed competition and increase yields in organic maize (Zea mays), tomato (Solanum lycopersicum) and green and red pepper crops (Capsicum annuum), but the profitability of this weed control tactic has not been assessed. Our objective was to determine the profitability of abrasive weeding using empirical yield data from three previously published studies, a range of crop prices and revenues, and a range of costs for wages, grit applicator ownership, tractor use, abrasive grits, and fuel. Results suggest that abrasive weeding was not profitable in organic maize production, and may reduce net income by US$223–3537 ha−1 compared with inter-row cultivation alone for weed control. The cost of abrasive weeding in maize was largely dependent on the cost of abrasive grits and the cost to own a four-row grit applicator (US$736–2105 yr−1). However, abrasive weeding was less expensive than hand weeding, especially as the scale of production increased. Abrasive weeding was profitable in tomato and pepper crops and increased net mean income by US$12,251–33,265 ha−1. However, abrasive weeding was not 100% effective and hand weeding for weed-free conditions was always the most profitable approach to in-row weed management in vegetable crops. The profit potential of the hand-weeded, weed-free treatments demonstrates the importance of weed control in high-value specialty crops–even those grown in plastic mulch film. Despite the profit potential for hand weeding observed here, labor is increasingly difficult to source, retain and afford, and abrasive weeding offers a mechanical alternative with 66% less labor required. Further research is needed to improve the efficacy of abrasive weeding and to reduce the cost of abrasive grits and application.
The intellectual, artistic, and architectural accomplishments of Maya elites during the Classic period were extraordinary, and evidence of elite activities has preserved well in the archaeological record. A centuries-long research focus on elites has understandably fostered the view that they controlled the economy, politics, and religion of Maya civilization. While there has been significant progress in household archaeology, unfortunately the activities, decisions, and interactions of commoners generally preserve poorly in the archaeological record. Therefore, it has been challenging to understand the sociopolitical economy of commoners, and how it related—or did not relate—to elite authority. The exceptional volcanic preservation of the site of Cerén, El Salvador, provides a unique opportunity to explore the degree to which elites controlled or influenced commoner life. Was society organized in a top-down hierarchy in which elites controlled everything? Or did commoners have autonomy, and thus the authority to decide quotidian, seasonal, and annual issues within the village? Or was there a mixture of different loci of authority within the village and the region? Research at Cerén is beginning to shed some light on the sociopolitical economy within the community and in relation to elites in the Zapotitan valley. A domain in which there was considerable commoner-elite interaction in the Cerén area was the marketplace. Elites and their attached specialists provided products, and commoners decided which marketplace they would attend to exchange their items. Evidence from Cerén also suggests that there were numerous other domains of authority within the community that had no detectable control or influence from outside. For instance, people in the village decided what crafts or specialized agricultural products to produce as surplus to be exchanged within the community for different products from other households. Cerén community members acted independently as individuals, as households, or in other domains within the community. Understanding the multiple layers of authority at Cerén sheds light on the sociopolitical organization in one non-elite Classic period Maya community.
Trap crops are a plausible control strategy for the wheat stem sawfly (WSS), Cephus cinctus Norton (Hymenoptera: Cephidae), especially in alternate wheat−fallow cropping systems. Identifying the most suitable winter wheat (Triticum aestivum L., Poaceae) cultivars is necessary to further improve the effectiveness of winter wheat trap crops. We compared cultivars suitable for cultivation in Montana to identify those that exhibit the greatest potential as trap crops. To accomplish this we used nine winter wheat cultivars to analyze plant characteristics that influence the oviposition behavior of the WSS: stem height, stem diameter, rate of plant development, and emission of the WSS attractant (Z)-3-hexenyl acetate. Data on sawfly-induced stem cutting collected from these cultivars in field nurseries were analyzed to evaluate the potential of each cultivar to attract sawflies. Based on these criteria, five cultivars with good potential as trap crops are ‘Norstar’, ‘Neeley’, ‘Morgan’, ‘Rampart’, and ‘BigSky’. More data from laboratory preference tests and detailed measurement of semiochemical production from these cultivars are required for selecting optimal cultivars for trap-cropping.
Anecdotal and biographical reports suggest that bipolar disorder may be
associated with high IQ or creativity, but evidence for any such
connection is weak.
To investigate possible associations between scholastic achievement and
later bipolar disorder, using prospective data, in a whole-population
Using individual school grades from all individuals finishing compulsory
schooling in Sweden between 1988 and 1997, we tested associations between
scholastic achievement at age 15–16 and hospital admission for psychosis
between ages 17 and 31, adjusting for potential confounders.
Individuals with excellent school performance had a nearly fourfold
increased risk of later bipolar disorder compared with those with average
grades (hazard ratio HR = 3.79, 95% CI 2.11–6.82). This association
appeared to be confined to males. Students with the poorest grades were
also at moderately increased risk of bipolar disorder (HR = 1.86, 95% CI
These findings provide support for the hypothesis that exceptional
intellectual ability is associated with bipolar disorder.
There is abundant evidence that schizophrenia is associated with cognitive deficits in childhood. However, previous studies investigating school performance have been inconclusive. Furthermore, there are several biological and social factors that could confound the association. We investigated whether school performance at age 16 is associated with risk of adult schizophrenia and other psychoses in a large national cohort, while controlling for multiple confounders.
Using a national sample of 907 011 individuals born in Sweden between 1973 and 1983, we used Cox regression to assess whether scholastic achievement at age 15–16 predicted hospital admission for psychosis between ages 17 and 31, adjusting for potential confounders.
Poor school performance was associated with increased rates of schizophrenia [hazard ratio (HR) 3.9, 95% confidence interval (CI) 2.8–5.3], schizo-affective disorder (HR 4.2, 95% CI 1.9–9.1) and other psychoses (HR 3.0, 95% CI 2.3–4.0). Receiving the lowest (E) grade was significantly associated with risk for schizophrenia and other psychoses in every school subject. There was no evidence of confounding by migrant status, low birthweight, hypoxia, parental education level or socio-economic group.
Poor school performance across all domains is strongly associated with risk for schizophrenia and other psychoses.
The aim of the study was to elicit the views of senior house officers in psychiatry across London regarding the factors that influence their decision whether to pursue a career in child and adolescent psychiatry. Postal questionnaires were sent to a random sample of all senior house officers on London psychiatry training schemes.
Of the respondents who recalled being taught child psychiatry at medical school, 91% found it interesting and 73% found it useful. Of those who recalled having such teaching during psychiatric training, 90% found it interesting and 85% found it useful. However, this had no significant impact upon subsequent career choice. Experience of working as a senior house officer in child psychiatry did influence future career intentions. Trainees who identified such placements as providing good clinical experience or job satisfaction were significantly more likely to consider the specialty for a future career.
Consultants and managers should create and maintain senior house officer posts that will encourage trainees to perceive the specialty as a future career.
Recovery from brain injury is an extended and arduous process. It is estimated that a full 18 months or more are required to obtain the maximum benefit of natural recovery following a traumatic brain injury (TBI) (Dikmen et al., 1995), while recovering from a stroke can continue for many years (Speach and Dombovy, 1995). Acute rehabilitative efforts for those who have suffered neurological insult typically begin once a patient is judged to be medically stable and transferred to an inpatient rehabilitation unit. Multidisciplinary programmes provide ongoing medical care and seek to address deficits in basic activities of daily living such as orientation, mobility, feeding and communication. Also, an initial assessment of gross cognitive skills is typically conducted. Depending upon progress and perceived need, patients are either discharged home or transferred to a postacute rehabilitation programme. Malec and Basford (1996) provide a hierarchy of the types of brain injury-rehabilitation programmes, with a basic division into subacute and postacute categories. The subacute rehabilitation setting provides long-term residential care for those with such severe deficits that they cannot meaningfully participate in further rehabilitative efforts. These types of people typically include those who require coma management or whose severe behavioural problems preclude ongoing rehabilitation and demand a very intensive level of management.
Malec and Basford (1996) further stratify postacute rehabilitation programmes, with the most restrictive being neurobehavioural programmes.
Both Harold Laski and C. B. Macpherson attempted to reconcile elements of liberalism and Marxism in their work. Macpherson offered a clearer and more precise argument about the ways in which capitalist market relations frustrate freedom, equality and the development of the individual. Laski provided a clearer and more consistent account of human nature, which is necessary to sustain such an argument. Macpherson, in turn, reformulated the distinction between negative and positive liberty, which had remained an unresolved problem in Laski's account of human nature. The respective strengths of Laski and Macpherson may be combined to provide a coherent and cogent ideological position.
We tested the hypothesis that tree species in a subtropical rain forest in
south-east Queensland are ecologically equivalent and therefore have identical environmental
requirements for their regeneration. We assessed the evidence that juveniles of species differed
in their distributions in treefall gap microsites and along gradients of light availability,
soil pH, soil PO4-P availability and soil NO3-N availability. Pairwise comparisons were
made on a subset of the common species selected on the basis that they showed a relatively
high level of positive association, and would therefore, a priori, be expected to have similar
regeneration requirements. Detailed comparisons between the species failed to demonstrate
evidence for species differentiation with respect to their tolerance of the disturbance associated
with gap microsites or to the gradient of NO3-N availability. However, species differed
markedly in their distributions along the soil pH gradient and along the gradients of light
availability and soil PO4-P availability. The overall level of ecological differentiation
between the species is high: seven out of the 10 possible species pairings showed evidence for
ecological differentiation. Such niche differentiation amongst the juveniles of tree species
may play an important role in maintaining the species richness of rain-forest communities.
All stems ≥ 1 cm dbh were measured, tagged, mapped and identified on a 1-ha plot of rain forest at Gambubal State Forest, south-east Queensland, Australia. The spatial patterns and size class distributions of 11 common tree species on the plot were assessed to search for mechanisms determining their distribution and abundance. The forest was species-poor in comparison to many lowland tropical forests and the common species are therefore present at relatively high densities. Despite this, only limited evidence was found for the operation of density-dependent processes at Gambubal. Daphnandra micrantha saplings were clumped towards randomly spaced adults, indicating a shift of distribution over time caused by differential mortality of saplings in these adult associated clumps. Ordination of the species composition in 25-m × 25-m subplots revealed vegetation gradients at that scale, which corresponded to slope across the plot. Adult basal area was dominated by a few large individuals of Sloanea woollsii but the comparative size class distributions and replacement probabilities of the 11 common species suggest that the forest will undergo a transition to a more mixed composition if current conditions persist. The current cohort of large S. woollsii individuals probably established after a large-scale disturbance event and the forest has not attained an equilibrium species composition.
This chapter reviews historical observations concerning malingering. It discusses the techniques currently used to detect malingering of memory deficits. The essential feature of malingering is that symptoms are intentionally produced, indicating malingerers must have self-awareness of the falseness of their symptoms. A number of techniques have been developed with the specific goal of helping the clinician to determine if an examinee is not exerting maximum effort on a task. Among those used to detect feigned memory disorders are Rey's 15-Item Memory Test, Rey's Word Recognition List, and various versions of symptom validity tests. Individuals instructed to simulate memory impairment on standardized memory tests often perform worse than patients with known brain dysfunction, particularly on recognition tasks. Use of such data from established clinical tests provides the additional benefits of diagnostically relevant information without the time and expense of administering procedures specifically designed to detect malingering.
It is well known that there exist infinite closed subsets
E of [ ] such that A(E) = C(E)
(see, for example, ). Such sets are called Helson sets.
Let E be a closed subset of [ ], let
0 < α < 1, and let Aα(E) be the
restriction of the Beurling algebra Aα([ ]).
Then Aα(E) ⊂ lipαE.
We shall show that Aα(E) = lipαE
if and only if E is finite. This answers a question raised by Pedersen
, where partial results were obtained.
This paper examines the development of the concept of brain death and of the criteria necessary for its recognition. Competing formulations of brain death are assessed and the case for a ‘brainstem’ concept of death is argued. Attention is finally drawn to some of the ethical issues raised by the use of neurological criteria in the diagnosis of human death.