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A retrospective naturalistic evaluation was undertaken to identify if pre- and post-disaster factors may predict the likelihood of those considered “at risk” of post-traumatic stress disorder (PTSD) entering a post-disaster clinical treatment program.
Methods
The intake data of 881 people referred to the program following the Queensland (Australia) natural disasters of 2010-11 was evaluated. Those referred scored >2 on the Primary Care PTSD scale. Assessment included the disaster exposure experience, demographic and clinical information, and measures of coping and resilience. Descriptive analyses and a Classification Tree Analysis (CTA) were undertaken to ascertain which factors may predict treatment participation.
Results
The treatment group (TG) in comparison to the non-treatment group (NTG) were more likely to perceive their life was threatened (85.1% vs 8.1%), less able to cope (67% vs 25.8%) and less resilient (4.2% vs 87.5%). The CTA using all the assessment variables found the Connor-Davidson (2-item scale) (P < 0.001), degree of property damage (P < 0.001), financial losses (P < 0.001), perception their life was threatened (P < 0.001) and insurance claims (P < 0.003) distinguished the TG from the NTG.
Conclusions
The study identified factors that distinguished the TG from the NTG and predicted the likelihood of participation in a post-disaster mental health treatment.
Motor neuron disease (MND) is a progressive, fatal, neurodegenerative condition that affects motor neurons in the brain and spinal cord, resulting in loss of the ability to move, speak, swallow and breathe. Acceptance and commitment therapy (ACT) is an acceptance-based behavioural therapy that may be particularly beneficial for people living with MND (plwMND). This qualitative study aimed to explore plwMND’s experiences of receiving adapted ACT, tailored to their specific needs, and therapists’ experiences of delivering it.
Method:
Semi-structured qualitative interviews were conducted with plwMND who had received up to eight 1:1 sessions of adapted ACT and therapists who had delivered it within an uncontrolled feasibility study. Interviews explored experiences of ACT and how it could be optimised for plwMND. Interviews were audio recorded, transcribed and analysed using framework analysis.
Results:
Participants were 14 plwMND and 11 therapists. Data were coded into four over-arching themes: (i) an appropriate tool to navigate the disease course; (ii) the value of therapy outweighing the challenges; (iii) relevance to the individual; and (iv) involving others. These themes highlighted that ACT was perceived to be acceptable by plwMND and therapists, and many participants reported or anticipated beneficial outcomes in the future, despite some therapeutic challenges. They also highlighted how individual factors can influence experiences of ACT, and the potential benefit of involving others in therapy.
Conclusions:
Qualitative data supported the acceptability of ACT for plwMND. Future research and clinical practice should address expectations and personal relevance of ACT to optimise its delivery to plwMND.
Key learning aims
(1) To understand the views of people living with motor neuron disease (plwMND) and therapists on acceptance and commitment therapy (ACT) for people living with this condition.
(2) To understand the facilitators of and barriers to ACT for plwMND.
(3) To learn whether ACT that has been tailored to meet the specific needs of plwMND needs to be further adapted to potentially increase its acceptability to this population.
This editorial considers the value and nature of academic psychiatry by asking what defines the specialty and psychiatrists as academics. We frame academic psychiatry as a way of thinking that benefits clinical services and discuss how to inspire the next generation of academics.
Digital Mental Health Interventions (DMHIs) that meet the definition of a medical device are regulated by the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK. The MHRA uses procedures that were originally developed for pharmaceuticals to assess the safety of DMHIs. There is recognition that this may not be ideal, as is evident by an ongoing consultation for reform led by the MHRA and the National Institute for Health and Care Excellence.
Aims
The aim of this study was to generate an experts’ consensus on how the medical regulatory method used for assessing safety could best be adapted for DMHIs.
Method
An online Delphi study containing three rounds was conducted with an international panel of 20 experts with experience/knowledge in the field of UK digital mental health.
Results
Sixty-four items were generated, of which 41 achieved consensus (64%). Consensus emerged around ten recommendations, falling into five main themes: Enhancing the quality of adverse events data in DMHIs; Re-defining serious adverse events for DMHIs; Reassessing short-term symptom deterioration in psychological interventions as a therapeutic risk; Maximising the benefit of the Yellow Card Scheme; and Developing a harmonised approach for assessing the safety of psychological interventions in general.
Conclusion
The implementation of the recommendations provided by this consensus could improve the assessment of safety of DMHIs, making them more effective in detecting and mitigating risk.
Australia has just rescheduled two drugs controlled under the United Nations Psychotropic Drug Conventions, psilocybin and MDMA, as treatments for treatment-resistant depression and post-traumatic stress disorder respectively. This feature explores the reasons for these developments, the opportunities and challenges they provide to psychiatry communities and how along with health systems these communities might respond to these developments.
Understanding historical environmental determinants associated with the risk of elevated marine water contamination could enhance monitoring marine beaches in a Canadian setting, which can also inform predictive marine water quality models and ongoing climate change preparedness efforts. This study aimed to assess the combination of environmental factors that best predicts Escherichia coli (E. coli) concentration at public beaches in Metro Vancouver, British Columbia, by combining the region’s microbial water quality data and publicly available environmental data from 2013 to 2021. We developed a Bayesian log-normal mixed-effects regression model to evaluate predictors of geometric E. coli concentrations at 15 beaches in the Metro Vancouver Region. We identified that higher levels of geometric mean E. coli levels were predicted by higher previous sample day E. coli concentrations, higher rainfall in the preceding 48 h, and higher 24-h average air temperature at the median or higher levels of the 24-h mean ultraviolet (UV) index. In contrast, higher levels of mean salinity were predicted to result in lower levels of E. coli. Finally, we determined that the average effects of the predictors varied highly by beach. Our findings could form the basis for building real-time predictive marine water quality models to enable more timely beach management decision-making.
The range of roles in healthcare knowledge and library services are many and varied. From 'traditional' librarian roles to those that break new ground - including clinical, embedded and outreach librarians and knowledge managers - they are a vital ongoing support for this important sector.
This work brings together health information practitioners and researchers with a variety of experience across health information work within knowledge and library services in the NHS. It provides a comprehensive, practitioner-focused introduction to all aspects of knowledge and library work in the health sector with a focus on NHS England. The book begins with an overview of the NHS and how knowledge and library work sit within it. It then addresses such critical areas as services supporting evidence-based practice, the developing area of health information literacy, reflective practice, collaborative working, demonstrating impact and employing digital technology. The book ends with an exploration of what the future might hold for healthcare knowledge and library services such as, the rapid advance of artificial intelligence/machine learning and how it might shape those services and knowledge specialist roles.
Knowledge and library specialists offer a valuable gift to healthcare professionals - the 'gift of time' enabling them to make informed decisions which directly impact upon patient care. This timely book provides a valuable reference for anyone studying or looking to enter this relevant and diverse field.
Working in a health organisation can be a bewildering experience for new knowledge and library service (KLS) staff. Such organisations often have thousands of highly pressured clinical and managerial staff spread across multiple sites, with little time to explain how things work and what all the jargon means.
The good news is that, as a knowledge and library professional, you are already equipped to do lots of finding out for yourself:
• Start digging, start a set of notes, start a glossary or a set of questions.
• If it helps, draw up organisational and staff structures. A visual representation works better for some people.
• Network with knowledge and library colleagues in other health care organisations.
Our experience shows that these come in useful when you, in turn, are helping new staff understand the complex world they have just joined. One of the authors of this chapter used their diagram of the English National Health Service (NHS) as part of the induction for a finance director who had come from a non-health background, earning his gratitude and a friendly smile ever after.
This chapter will help you structure your voyage of discovery as you work out what your new organisation is all about and how it fits into the wider healthcare system of your country. It will also get you thinking about health in its wider societal context.
As we write, the COVID pandemic is an example of a worldwide issue, affecting every person in every country. Knowledge and library specialists play an important role in enabling fellow health staff, the public, patients, families and carers locate and, crucially, use high quality knowledge resources. The services provided by healthcare knowledge and library services ‘take the “heavy lifting” out of getting evidence into practice and give the “gift of time” to healthcare professionals’ (Economics by Design, 2020).
A word on terminology before we get started. We will generally use knowledge and library specialist to mean a person qualified in librarianship to at least degree level, or someone who aspires to be. This term covers a broad spectrum of roles across healthcare including, but not limited to, librarian, information professional and knowledge specialist. Most of our examples will come from the NHS but we believe you will be able to take the questions we think you should ask, find the answers and then apply them in your own home setting.
We recently reported on the radio-frequency attenuation length of cold polar ice at Summit Station, Greenland, based on bi-static radar measurements of radio-frequency bedrock echo strengths taken during the summer of 2021. Those data also allow studies of (a) the relative contributions of coherent (such as discrete internal conducting layers with sub-centimeter transverse scale) vs incoherent (e.g. bulk volumetric) scattering, (b) the magnitude of internal layer reflection coefficients, (c) limits on signal propagation velocity asymmetries (‘birefringence’) and (d) limits on signal dispersion in-ice over a bandwidth of ~100 MHz. We find that (1) attenuation lengths approach 1 km in our band, (2) after averaging 10 000 echo triggers, reflected signals observable over the thermal floor (to depths of ~1500 m) are consistent with being entirely coherent, (3) internal layer reflectivities are ≈–60$\to$–70 dB, (4) birefringent effects for vertically propagating signals are smaller by an order of magnitude relative to South Pole and (5) within our experimental limits, glacial ice is non-dispersive over the frequency band relevant for neutrino detection experiments.
COVID-19 had the potential to dramatically increase public support for welfare. It was a time of apparent increased solidarity, of apparently deserving claimants, and of increasingly widespread exposure to the benefits system. However, there are also reasons to expect the opposite effect: an increase in financial strain fostering austerity and self-interest, and thermostatic responses to increasing welfare generosity. In this paper, we investigate the effects of the pandemic on attitudes towards working-age unemployment benefits in the UK using a unique combination of data sources: (i) temporally fine-grained data on attitudinal change over the course of the pandemic; and (ii) a novel nationally representative survey contrasting attitudes towards pandemic-era and pre-pandemic claimants (including analysis of free-text responses). Our results show that the pandemic prompted little change in UK welfare attitudes. However, we also find that COVID-era unemployment claimants were perceived as substantially more deserving than those claiming prior to the pandemic. This contrast suggests a strong degree of ‘COVID exceptionalism’ – with COVID claimants seen as categorically different from conventional claimants, muting the effect of the pandemic on welfare attitudes overall.
The U.S. Department of Agriculture–Agricultural Research Service (USDA-ARS) has been a leader in weed science research covering topics ranging from the development and use of integrated weed management (IWM) tactics to basic mechanistic studies, including biotic resistance of desirable plant communities and herbicide resistance. ARS weed scientists have worked in agricultural and natural ecosystems, including agronomic and horticultural crops, pastures, forests, wild lands, aquatic habitats, wetlands, and riparian areas. Through strong partnerships with academia, state agencies, private industry, and numerous federal programs, ARS weed scientists have made contributions to discoveries in the newest fields of robotics and genetics, as well as the traditional and fundamental subjects of weed–crop competition and physiology and integration of weed control tactics and practices. Weed science at ARS is often overshadowed by other research topics; thus, few are aware of the long history of ARS weed science and its important contributions. This review is the result of a symposium held at the Weed Science Society of America’s 62nd Annual Meeting in 2022 that included 10 separate presentations in a virtual Weed Science Webinar Series. The overarching themes of management tactics (IWM, biological control, and automation), basic mechanisms (competition, invasive plant genetics, and herbicide resistance), and ecosystem impacts (invasive plant spread, climate change, conservation, and restoration) represent core ARS weed science research that is dynamic and efficacious and has been a significant component of the agency’s national and international efforts. This review highlights current studies and future directions that exemplify the science and collaborative relationships both within and outside ARS. Given the constraints of weeds and invasive plants on all aspects of food, feed, and fiber systems, there is an acknowledged need to face new challenges, including agriculture and natural resources sustainability, economic resilience and reliability, and societal health and well-being.
Attention-deficit/hyperactivity disorder (ADHD) is associated with a range of adverse outcomes. One of many potential adverse trajectories for those with ADHD is involvement in criminal offending. Meta-analyses have reported increased prevalence rates of ADHD in youth and adult offender populations. The prevalence of comorbid disorders in offender populations is common, but this appears to be increased in those with ADHD, which in turn complicates diagnosis and treatment. This chapter outlines the prevalence of ADHD in offender populations and considers gender and cultural effects. The relationship between ADHD and criminal offending is discussed, including the onset and type of offending, recidivism, progress within institutional establishments, comorbidity and long-term consequences. theoretical frameworks for understanding the association between ADHD and criminal offending are also considered. The chapter also highlights the economic consequences of ADHD within offender populations and more broadly within society. We consider system barriers and practical strategies that may be implemented to identify and meet the needs of offenders with ADHD.
The aim of this study was to observe the level of alcohol-based sanitizer, mask use, and physical distancing across indoor community settings in Guelph, ON, Canada, and to identify potential barriers to practicing these behaviors.
Methods:
Shoppers were observed in June 2022 across 21 establishments. Discrete in-person observations were conducted and electronically recorded using smartphones. Multilevel logistic regression models were fitted to identify possible covariates for the 3 behavioral outcomes.
Results:
Of 946 observed shoppers, 69% shopped alone, 72% had at least 1 hand occupied, 26% touched their face, 29% physically distanced ≥ 2 m, 6% used hand sanitizer, and 29% wore masks. Sanitizer use was more commonly observed among people who wore masks and in establishments with coronavirus disease (COVID-19) signage posted at the entrance. Mask use was more commonly observed during days without precipitation and in establishments with some or all touch-free entrances. Shoppers more commonly physically distanced ≥ 2 m when they were shopping alone.
Conclusions:
This supports evidence for environmental context influencing COVID-19 preventive behaviors. Intervention efforts aimed at visible signage, tailored messaging, and redesigning spaces to facilitate preventive behaviors may be effective at increasing adherence during outbreaks.