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Despite the critical role families play in the care and recovery journeys of people who experience enduring mental distress, they are often excluded by the mental health services in the care and decision-making process. International trends in mental health services emphasise promoting a partnership approach between service users, families and practitioners within an ethos of recovery.
This paper evaluated the acceptability of and initial outcomes from a clinician and peer co-led family information programme.
A sequential design was used involving a pre-post survey to assess changes in knowledge, confidence, advocacy, recovery and hope following programme participation and interviews with programme participants. Participants were recruited from mental health services running the information programme. In all, 86 participants completed both pre- and post-surveys, and 15 individuals consented to interviews.
Survey findings indicated a statistically significant change in family members’ knowledge about mental health issues, recovery attitudes, sense of hope and confidence. In addition, the interviews suggested that the programme had a number of other positive outcomes for family members, including increased communication with members of the mental health team and increased awareness of communication patterns within the family unit. Family members valued the opportunity to share their experiences in a ‘safe’ place, learn from each other and provide mutual support.
The evaluation highlights the importance of developing information programmes in collaboration with family members as well as the strength of a programme that is jointly facilitated by a family member and clinician.
Depression is considered to have the highest disability burden of all conditions. Although treatment-resistant depression (TRD) is a key contributor to that burden, there is little understanding of the best treatment approaches for it and specifically the effectiveness of available augmentation approaches.
We conducted a systematic review and meta-analysis to search and quantify the evidence of psychological and pharmacological augmentation interventions for TRD.
Participants with TRD (defined as insufficient response to at least two antidepressants) were randomised to at least one augmentation treatment in the trial. Pre-post analysis assessed treatment effectiveness, providing an effect size (ES) independent of comparator interventions.
Of 28 trials, 3 investigated psychological treatments and 25 examined pharmacological interventions. Pre-post analyses demonstrated N-methyl-d-aspartate-targeting drugs to have the highest ES (ES = 1.48, 95% CI 1.25–1.71). Other than aripiprazole (four studies, ES = 1.33, 95% CI 1.23–1.44) and lithium (three studies, ES = 1.00, 95% CI 0.81–1.20), treatments were each investigated in less than three studies. Overall, pharmacological (ES = 1.19, 95% CI 1.08–1.30) and psychological (ES = 1.43, 95% CI 0.50–2.36) therapies yielded higher ESs than pill placebo (ES = 0.78, 95% CI 0.66–0.91) and psychological control (ES = 0.94, 95% CI 0.36–1.52).
Despite being used widely in clinical practice, the evidence for augmentation treatments in TRD is sparse. Although pre-post meta-analyses are limited by the absence of direct comparison, this work finds promising evidence across treatment modalities.
Declaration of interest
In the past 3 years, A.H.Y. received honoraria for speaking from AstraZeneca, Lundbeck, Eli Lilly and Sunovion; honoraria for consulting from Allergan, Livanova and Lundbeck, Sunovion and Janssen; and research grant support from Janssen. In the past 3 years, A.J.C. received honoraria for speaking from AstraZeneca and Lundbeck; honoraria for consulting with Allergan, Janssen, Livanova, Lundbeck and Sandoz; support for conference attendance from Janssen; and research grant support from Lundbeck. B.B. has recently been (soon to be) on the speakers/advisory board for Hexal, Lilly, Lundbeck, Mundipharma, Pfizer, and Servier. No other conflicts of interest.
The Institute of Translational Health Sciences (ITHS), a Clinical and Translational Science Award (CTSA)-funded program at the University of Washington (UW), established the Drug and Device Advisory Committee (DDAC) to provide product-specific scientific and regulatory mentoring to investigators seeking to translate their discoveries into medical products. An 8-year retrospective analysis was undertaken to evaluate the impact of the DDAC programs on commercialization metrics.
Tracked metrics included the number of teams who consulted with the DDAC, initiated a clinical trial, formed a startup, or were successful obtaining federal small business innovation awards or venture capital. The review includes historical comparisons of the startup rates for the UW School of Medicine and the Fred Hutchinson Cancer Research Center, two ITHS-affiliated institutions that have had different DDAC utilization rates.
Between 2008 and 2016, the DDAC supported 161 unique project teams, 28% of which went on to form a startup. The commercialization rates for the UW School of Medicine increased significantly following integration of the DDAC into the commercialization programs offered by the UW technology transfer office.
A formalized partnership between preclinical consulting and the technology transfer programs provides an efficient use of limited development funds and a more in-depth vetting of the business opportunity and regulatory path to development.
We present very deep JHK imaging of the Trapezium Cluster obtained with Gemini South/Flamingos and Gemini North/Hōkūpa'a. These images probe the IMF down to ˜ 2 MJup in a total area of ˜ 8 arcmin2. Several very faint new planetary mass candidates are detected and sources previously detected with UKIRT are verified. Photometry of 124 point sources in this field produces a Luminosity Function which drops to zero at K=18.75. Allowing for modest extinction this corresponds to a possible turn-down in the IMF near 5 Mjup. A minority of PMOs exhibit large K band excesses attributed to hot dust, confirming their extreme youth. Some of the faintest sources are associated with short trails of light of uncertain nature. These may provide a clue to the origin of PMOs, perhaps marking evacuated paths cleared by rapidly moving objects.
Red spectra of a sample of low-mass stars and brown dwarfs in the Orion Trapezium cluster are discussed. They show late-type spectral characteristics confirming cluster membership and some show evidence of circumstellar activity.
In no other society in the world have urbanisation and industrialization been as comprehensively based on migrant labour as in South Africa. Rather than focusing on the well-documented narrative of displacement and oppression, A Long Way Home captures the humanity, agency and creative modes of self-expression of the millions of workers who helped to build and shape modern South Africa. The book spans a three-hundred-year history beginning with the exportation of slave labour from Mozambique in the eighteenth century and ending with the strikes and tensions on the platinum belt in recent years. It shows not only the age-old mobility of African migrants across the continent but also, with the growing demand for labour in the mining industry, the importation of Chinese indentured migrant workers. Contributions include 18 essays and over 90 artworks and photographs that traverse homesteads, chiefdoms and mining hostels, taking readers into the materiality of migrant life and its customs and traditions, including the rituals practiced by migrants in an effort to preserve connections to “home” and create a sense of “belonging”. The essays and visual materials provide multiple perspectives on the lived experience of migrant labourers and celebrate their extraordinary journeys. A Long Way Home was conceived during the planning of an art exhibition entitled ‘Ngezinyawo: Migrant Journeys’ at Wits Art Museum. The interdisciplinary nature of the contributions and the extraordinary collection of images selected to complement and expand on the text make this a unique collection.
Diffractive grating structures formed by electron beam lithography have been replicated into the surface of silver commemorative coins. The detailed features of the gratings and the depth of relief were accurately transferred from the resist master plate to the surface of the fine silver coins using a Ni shim as a replication tool. This method has produced an optically variable device (OVD) in the surface of the coins which exhibited a strong intensity of first order diffraction over the area of the image (3 × 1.5 cm). A feature of the grating structures formed in the coins were fine-scale protrusions located along the length of the ridges. The presence of these protrusions has been attributed to an adhesive transfer and back-transfer of Ag during the cycle of impact loading of the Ni shim for sequential coins.
This article provides an overview of the New Zealand Health, Work and Retirement Study (HWR), the focus of which is on determinants of cultural-contextual factors on physical and mental health among 6,662 New Zealand citizens, a nationally representative sample of adults between 55 and 70 years of age. The HWR was initiated in 2006 with two-year re-assessment intervals. The health and wellbeing of older Māori was a study priority as previous research has shown large health disparities between Māori and non-Māori in New Zealand. Persons of Māori origin were over-sampled to ensure adequate information for subsequent analyses. First-wave results indicated that socioeconomic status, social support and retirement status were associated with optimal ageing among older adults in New Zealand. Māori scored lower on markers of physical and mental health, which was partially explained by restrictive factors including reduced economic living standards and a propensity towards less physical activity. After controlling for multiple socio-contextual and biological variables, ethnicity continued to predict health, suggesting that there are other markers of health and wellbeing in ageing among Māori. Structural variables which restrict access to health care and predispose Māori to engage in maladaptive lifestyle behaviours combined with the distal effects of colonisation may contribute to the health disparities found between Māori and the majority population in New Zealand.
The nature of the relationship between duration of the pre-diagnostic
interval in schizophrenia and better outcomes remains unclear.
To re-examine data from one of the earliest studies suggesting an
association between long pre-treatment interval and compromised outcome,
assessing the relationship between symptomatic and social variables and
increased relapse risk at 1 year.
Symptomatic, social and demographic data from participants in the
Northwick Park Study of First Episodes who completed 12-month follow-up
(n = 101) were re-analysed in the context of duration
of untreated illness (DUI).
At admission, those with long DUI were more likely to have lower scores
on tension derived from the Present State Examination, exhibited more
behaviour threatening to others and more bizarre behaviour, were more
likely to be single, to live alone or dependently, to be unemployed and
to have experienced more adverse life events prior to admission. Logistic
regression showed that diminished tension, bizarre behaviour and
unemployed status independently increased the risk of relapse, bizarre
behaviour making the single biggest contribution. Tension did not remain
significant with log-transformation of data.
Findings are consistent with the conclusion that long DUI can reflect
characteristics of the psychosis itself rather than delay in