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It has been suggested that people with intellectual disabilities have a higher likelihood to develop psychiatric disorders, and that their treatment prognosis is relatively poor.
We aimed to establish the prevalence of intellectual disability in different mental healthcare settings, and estimate percentage of cognitive decline. We hypothesised that the prevalence of intellectual disabilities increases with intensity of care.
A cross-sectional study was conducted in different settings in a mental healthcare trust in the Netherlands. We used the Screener for Intelligence and Learning Disabilities (SCIL) to identify suspected mild intellectual disability (MID) or borderline intellectual functioning (BIF). We identified patients with a high level of education and low SCIL score to estimate which patients may have had cognitive decline.
We included 1213 consecutive patients. Over all settings, 41.4% of participating patients were positive for MID/BIF and 20.2% were positive for MID only. Prevalence of suspected MID/BIF increased by setting, from 27.1% in out-patient settings to 41.9% in flexible assertive community treatment teams and admission wards, to 66.9% in long-stay wards. Only 85 (7.1%) of all patients were identified as possibly having cognitive decline. Of these, 25.9% were in long-stay wards and had a diagnosis of schizophrenia or substance use disorder.
Low intellectual functioning is common in Dutch mental healthcare settings. Only a modest number of patients were identified as suffering from cognitive decline rather than suspected MID/BIF from birth. Therefore, we recommend improved screening of psychiatric patients for intellectual functioning at the start of treatment.
The first demonstration of laser action in ruby was made in 1960 by T. H. Maiman of Hughes Research Laboratories, USA. Many laboratories worldwide began the search for lasers using different materials, operating at different wavelengths. In the UK, academia, industry and the central laboratories took up the challenge from the earliest days to develop these systems for a broad range of applications. This historical review looks at the contribution the UK has made to the advancement of the technology, the development of systems and components and their exploitation over the last 60 years.
We summarize some of the past year's most important findings within climate change-related research. New research has improved our understanding of Earth's sensitivity to carbon dioxide, finds that permafrost thaw could release more carbon emissions than expected and that the uptake of carbon in tropical ecosystems is weakening. Adverse impacts on human society include increasing water shortages and impacts on mental health. Options for solutions emerge from rethinking economic models, rights-based litigation, strengthened governance systems and a new social contract. The disruption caused by COVID-19 could be seized as an opportunity for positive change, directing economic stimulus towards sustainable investments.
A synthesis is made of ten fields within climate science where there have been significant advances since mid-2019, through an expert elicitation process with broad disciplinary scope. Findings include: (1) a better understanding of equilibrium climate sensitivity; (2) abrupt thaw as an accelerator of carbon release from permafrost; (3) changes to global and regional land carbon sinks; (4) impacts of climate change on water crises, including equity perspectives; (5) adverse effects on mental health from climate change; (6) immediate effects on climate of the COVID-19 pandemic and requirements for recovery packages to deliver on the Paris Agreement; (7) suggested long-term changes to governance and a social contract to address climate change, learning from the current pandemic, (8) updated positive cost–benefit ratio and new perspectives on the potential for green growth in the short- and long-term perspective; (9) urban electrification as a strategy to move towards low-carbon energy systems and (10) rights-based litigation as an increasingly important method to address climate change, with recent clarifications on the legal standing and representation of future generations.
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Stronger permafrost thaw, COVID-19 effects and growing mental health impacts among highlights of latest climate science.
In recent years, nanoparticles have become a fashionable subject of research due to their sizes, shapes, and unique intrinsic physicochemical properties. In particular for the last 5 years, nano-Se has received tremendous attention in terms of its production, characteristic, and possible application for poultry/animal science and medical sciences. Indeed, Nano-Se is shown to be a potential source of Se for poultry/animal nutrition. However, there is an urgent need to address the questions related to nano-Se absorption, assimilation, and metabolism. It is not clear at present if major biological effects of nano-Se are due to Se-protein synthesis, direct antioxidant/prooxidant effects, or both. It is necessary to understand how metallic nano-Se can be converted into H2Se and further to SeCys to be incorporated into selenoproteins. The aforementioned issues must be resolved before nano-Se finds its way to animal/poultry production as a feed supplement and clearly this subject warrants further investigation.
Despite advances in endovascular interventions, including the introduction of drug-eluting stents (DES), high target lesion revascularization (TLR) rates still burden the treatment of symptomatic lower-limb peripheral arterial disease (PAD). EluviaTM, a novel, sustained-release, paclitaxel-eluting DES, was shown to further reduce TLRs when compared with the paclitaxel-coated Zilver® PTX® stent, in the IMPERIAL randomized controlled trial. This evaluation estimated the cost-effectiveness of Eluvia when compared with Zilver PTX in Australia, based on 12-month clinical outcomes from the IMPERIAL trial.
A state-transition, decision-analytic model with a 12-month time horizon was developed from an Australian public healthcare system perspective. Cost parameters were obtained from the Australian National Hospital Cost Data Collection Cost Report (2016–17). All costs were captured in Australian dollars (AUD), where AUD 1 = USD 0.69 (June 2020). Complete sets of clinical parameters (primary patency loss, TLR, amputation, and death) and cost parameters from their respective distributions were bootstrapped in samples of 1,000 patients, for each intervention arm of the model. One-way and probabilistic sensitivity analyses were performed.
At 12 months, modeled TLR rates were 4.5 percent for Eluvia and 8.9 percent for Zilver PTX, and mean total direct costs were AUD 6,537 [USD 4,511] and AUD 6,908 [USD 4,767], respectively (Eluvia average per patient savings; overall cohort=AUD 371 [USD 256]; diabetic cohort=AUD 625 [USD 431]). In probabilistic sensitivity analyses, Eluvia was cost-effective relative to Zilver PTX in 92.0 percent of all simulations at a threshold of $10,000 per TLR avoided. Eluvia was more effective and less costly (dominant) than Zilver PTX in 76.0 percent of simulations.
In the first year after the intervention, Eluvia was more effective and less costly than Zilver PTX, making Eluvia the dominant treatment strategy for treatment of symptomatic lower-limb PAD, from an Australian public healthcare system perspective. These findings should be considered when formulating policy and practice guidelines in the context of priority setting and making evidence-based resource allocation decisions for treatment of PAD in Australia.
In the present analysis, we study effects of the radiation reaction (RR) on the dynamics of charged particles submitted to the action of localized longitudinal high-frequency carriers travelling at the speed of light. As the wave's crests and troughs keep overtaking particles, dissipative RR forces tend to drag particles alongside the wave in an effort to reduce the relative wave–particle speed. Particles of course never reach the phase velocity of the wave, but are instead driven to an ever-growing velocity, towards the speed of light, while in the wave localization region. We developed a modified average Hamiltonian formalism capable of describing the intricacies of the corresponding dynamics. The modified formalism agrees with simulations and is of particular usefulness in the study of optimum values for the localization length and maximum wave amplitude.
The semi-slug, Parmarion martensi, is an intermediate host of the zoonotic nematode, Angiostrongylus cantonensis, the aetiological agent of neuroangiostrongyliasis or rat lungworm disease in humans. Rearing methods were developed for P. martensi to facilitate studies on nematode transmission and control. Parmarion martensi exhibited high survivorship when reared on a diet of dog food and fresh fruits and vegetables in temperature-controlled cabinets at 21.4°C, 98% relative humidity and 12:12 L:D cycle. Rearing containers were lined with moist paper towels for substrate and plastic pots were provided for hiding/resting and egg-laying. Under these conditions, time to first reproduction was 165.3 ± 12.3 days, fecundity was approximately 34.5 ± 7.8 eggs per adult, and hatch rate was 52.7 ± 3.2%. Survivorship post egg hatch was 86.2 ± 2.9% at 30 days (neonates had a mortality rate of about 14%) and 99% thereafter for up to a year. The demographics of laboratory-reared and wild-caught P. martensi were similar except for the weight of reproductive adults, which was significantly higher in laboratory-reared adults (4.0 ± 0.2 g) than in field-collected adults (1.5 ± 0.1 g).
The growing concern for ethics in applied linguistics may be attributed to attempts to stem the rising incidence of ethical lapses in order to ensure that the core ethical principles of (1) respect for persons, (2) yielding optimal benefits while minimizing harm, and (3) justice are preserved. Following a brief historical review of this topic, and building on the growing commitment to carry out ethical applied linguistic research, we map out seven research tasks that will enhance our understanding of how to extend this expanding research agenda. By inviting applied linguists to evaluate their methodological practices and those of their peers, we also argue for the need to develop the ethical dispositions of emerging applied linguists, with a view to create a more robust field.
DocuSky is a personal digital humanities platform for humanities scholars, which aims to become a platform on which a scholar can satisfy all her digital needs with no direct IT assistance. To this end, DocuSky provides tools for a scholar to download material from the Web and prepare (annotating, building metadata) her material, a one-click function to build a full-text searchable database, and tools for analysis and visualization. DocuSky advocates the separation of digital content and tools. Being an open platform, it encourages IT developers to build tools to suit scholars’ needs, and it has already incorporated several popular Web resources and external tools into its environment. Interoperability is ensured through the format DocuXML. In addition to describing the design principles of DocuSky, we will show its main features, together with several important tools and examples. DocuSky was originally developed for Sinological studies. We are enriching it to work in other languages.
Implicit memories like consumption habits and conditioned reactions to drug-related stimuli are operational in addiction and relapse. The affective startle paradigm is an attractive tool for the measurement of the incentive salience of drug-related cues. We tested whether the stronger appetitive valence of drug cues, shown in two recent startle studies in smokers, does persist after prolonged abstinence, and may thus contribute to relapse.
We examined the auditory startle reflex magnitude of mildly deprived (4-6 hours) heavy smokers (n = 24), former smokers (n = 16, mean abstinence interval 18 months), and non-smokers (n = 24) while they viewed smoking-related scenes or standardized unpleasant, neutral and pleasant control scenes from the International Affective Picture System.
As expected, non-smokers showed no appetitive reactions toward smoking-cues. In smokers, smoking-cues had both appetitive implicit (startle suppression) and explicit (ratings for valence and craving) motivational effects, resembling those of pleasant scenes and differing from neutral and unpleasant scenes. This effect was more pronounced in smokers who later relapsed after a smoking cessation program, and in smokers consuming less than 20 cigarettes per day. Former smokers, despite reporting no craving and negative reactions to smoking cues, still showed evidence of implicit appetitive valence of these cues.
Nicotine addiction results in automatic appetitive reactions to drug-cues, which does not vanish after prolonged abstinence and which may thus contribute to relapses. Heavy smoking may result in a progressive internalization of smoking habits and a decline in reactivity towards external smoking-associated cues.
Language policies generally seek to establish, regulate, and conform linguistic practices – whether explicit or implicit – that occur within an ‘authorized’ domain. While there are multiple levels (societal, institutional, and interpersonal) at which such policies are enacted (Hornberger & Johnson, 2007), academic institutions are often significant policy arbiters as they serve as crucial switchboards (Blommaert, 2010; De Costa, 2010) that connect policies at the societal and interpersonal levels. In particular, English medium of instruction (EMI) policies that mandate English as the primary means of academic content delivery have played a pivotal role in enabling universities in countries such as Bangladesh (Rahman & Mehar Singh, 2019), China (e.g., Hu, 2009; Song, 2019; Zhang, 2018), Saudi Arabia (Barnawi, 2018; Phan & Barnawi, 2015), and Vietnam (Phan, 2018) to establish themselves on the world stage and engage with the global community. Even though several scholars (e.g., Coleman, 2006; Jenkins, 2019a; Knight, 2013, 2016; Macaro et al., 2018) have investigated EMI policies across different contexts, the following central question concerning these policies still persists: in what ways has the implementation of EMI policies transformed the higher education sector, and subsequently affected primary social actors, such as students, teachers, and administrators embedded within these shifting contexts? These concerns, we posit, are amplified by the transnational movements of people and institutions (Duff, 2015) and the ever-increasing speed and agility with which TESOL as a field has to respond to the shifting tides of globalization (Barnawi, 2020). Given this conspicuous gap in an ever-evolving English language policy landscape, we set out to critically review previous works that have examined the implementation of EMI policies within a transnational higher education (TNHE) context. TNHE is characterized by the transformation of higher education across the globe (Knight, 2013; Kosmützky & Putty, 2016) as Western-based universities export models – driven by a neoliberal agenda to maximize financial profit – through the establishment of overseas branch campuses. In reviewing works that examine TNHE, we aim to stimulate dialogue on this contemporary phenomenon.
Late-life depression (LLD) is associated with poor social functioning. However, previous research uses bias-prone self-report scales to measure social functioning and a more objective measure is lacking. We tested a novel wearable device to measure speech that participants encounter as an indicator of social interaction.
Twenty nine participants with LLD and 29 age-matched controls wore a wrist-worn device continuously for seven days, which recorded their acoustic environment. Acoustic data were automatically analysed using deep learning models that had been developed and validated on an independent speech dataset. Total speech activity and the proportion of speech produced by the device wearer were both detected whilst maintaining participants' privacy. Participants underwent a neuropsychological test battery and clinical and self-report scales to measure severity of depression, general and social functioning.
Compared to controls, participants with LLD showed poorer self-reported social and general functioning. Total speech activity was much lower for participants with LLD than controls, with no overlap between groups. The proportion of speech produced by the participants was smaller for LLD than controls. In LLD, both speech measures correlated with attention and psychomotor speed performance but not with depression severity or self-reported social functioning.
Using this device, LLD was associated with lower levels of speech than controls and speech activity was related to psychomotor retardation. We have demonstrated that speech activity measured by wearable technology differentiated LLD from controls with high precision and, in this study, provided an objective measure of an aspect of real-world social functioning in LLD.
Weight gain among psychiatric inpatients is a widespread phenomenon. This change in body mass index (BMI) can be caused by several factors. Based on recent research, we assume the following factors are related to weight gain during psychiatric inpatient treatment: psychiatric medication, psychiatric diagnosis, sex, age, weight on admission and geographic region of treatment.
876 of originally recruited 2328 patients met the criteria for our analysis. Patients were recruited and examined in mental health care centres in Nigeria (N=265), Japan (N=145) and Western-Europe (Denmark, Germany and Switzerland; N=466).
There was a significant effect of psychiatric medication, psychiatric diagnoses and geographic region, but not age and sex, on BMI changes. Geographic region had a significant effect on BMI change, with Nigerian patients gaining significantly more weight than Japanese and Western European patients. Moreover, geographic region influenced the type of psychiatric medication prescribed and the psychiatric diagnoses. The diagnoses and psychiatric medication prescribed had a significant effect on BMI change.
In conclusion, we consider weight gain as a multifactorial phenomenon that is influenced by several factors. One can discuss a number of explanations for our findings, such as different clinical practices in the geographical regions (prescribing or admission strategies and access-to-care aspects), as well as socio-economic and cultural differences.
Until the past half-century, all agriculture and land management was framed by local institutions strong in social capital. But neoliberal forms of development came to undermine existing structures, thus reducing sustainability and equity. The past 20 years, though, have seen the deliberate establishment of more than 8 million new social groups across the world. This restructuring and growth of rural social capital within specific territories is leading to increased productivity of agricultural and land management systems, with particular benefits for those previously excluded. Further growth would occur with more national and regional policy support.
What is the role of Northeastern agricultural products in the US food system? This paper presents a typology that categorizes where agricultural production and distribution of a specific geographic area, in this case a multi-state region, fits within the US food system. The place of each food is defined based on its production volume, scope of distribution, market timing and agro-ecological niche. Six distinct roles that a region might play in supplying food are identified: (a) the region is a national production center, (b) the region is a seasonally important supplier, (c) regional production and distribution is the primary scale for supplying a food, (d) the product occupies an agro-ecological niche, (e) a product is a co-product of another industry in the region, and (f) the product is marketed explicitly for its geographic provenance as a local or regional product. Illustrative examples of each role are provided from the research of the Enhancing Food Security in the Northeast (EFSNE) regional food systems project. The examples draw from a variety of methodological approaches including regional self-reliance analysis, product case studies, supply chain models, and examination of spatial and temporal patterns in crop and livestock production and marketing. While presented in the context of the Northeast, the typology would likely be valuable for characterizing other regions of the country. We need such a typology to better understand and communicate the value of geographically dispersed agricultural production to creating a resilient food system, thereby improving our decisions of how to respond to future agricultural challenges
The diet of most adults is low in fish and, therefore, provides limited quantities of the long-chain, omega-3 fatty acids (LCn-3FAs), eicosapentaenoic and docosahexaenoic acids (EPA, DHA). Since these compounds serve important roles in the brain, we sought to determine if healthy adults with low-LCn-3FA consumption would exhibit improvements in neuropsychological performance and parallel changes in brain morphology following repletion through fish oil supplementation.
In a randomized, controlled trial, 271 mid-life adults (30–54 years of age, 118 men, 153 women) consuming ⩽300 mg/day of LCn-3FAs received 18 weeks of supplementation with fish oil capsules (1400 mg/day of EPA and DHA) or matching placebo. All participants completed a neuropsychological test battery examining four cognitive domains: psychomotor speed, executive function, learning/episodic memory, and fluid intelligence. A subset of 122 underwent neuroimaging before and after supplementation to measure whole-brain and subcortical tissue volumes.
Capsule adherence was over 95%, participant blinding was verified, and red blood cell EPA and DHA levels increased as expected. Supplementation did not affect performance in any of the four cognitive domains. Exploratory analyses revealed that, compared to placebo, fish oil supplementation improved executive function in participants with low-baseline DHA levels. No changes were observed in any indicator of brain morphology.
In healthy mid-life adults reporting low-dietary intake, supplementation with LCn-3FAs in moderate dose for moderate duration did not affect neuropsychological performance or brain morphology. Whether salutary effects occur in individuals with particularly low-DHA exposure requires further study.