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Natural disasters are increasing in frequency and impact; they cause widespread disruption and adversity throughout the world. The Canterbury earthquakes of 2010–2011 were devastating for the people of Christchurch, New Zealand. It is important to understand the impact of this disaster on the mental health of children and adolescents.
To report psychiatric medication use for children and adolescents following the Canterbury earthquakes.
Dispensing data from community pharmacies for the medication classes antidepressants, antipsychotics, anxiolytics, sedatives/hypnotics and methylphenidate are routinely recorded in a national database. Longitudinal data are available for residents of the Canterbury District Health Board (DHB) and nationally. We compared dispensing data for children and adolescents residing in Canterbury DHB with national dispensing data to assess the impact of the Canterbury earthquakes on psychotropic prescribing for children and adolescents.
After longer-term trends and population adjustments are considered, a subtle adverse effect of the Canterbury earthquakes on dispensing of antidepressants was detected. However, the Canterbury earthquakes were not associated with higher dispensing rates for antipsychotics, anxiolytics, sedatives/hypnotics or methylphenidate.
Mental disorders or psychological distress of a sufficient severity to result in treatment of children and adolescents with psychiatric medication were not substantially affected by the Canterbury earthquakes.
Healthcare personnel (HCP) were recruited to provide serum samples, which were tested for antibodies against Ebola or Lassa virus to evaluate for asymptomatic seroconversion.
From 2014 to 2016, 4 patients with Ebola virus disease (EVD) and 1 patient with Lassa fever (LF) were treated in the Serious Communicable Diseases Unit (SCDU) at Emory University Hospital. Strict infection control and clinical biosafety practices were implemented to prevent nosocomial transmission of EVD or LF to HCP.
All personnel who entered the SCDU who were required to measure their temperatures and complete a symptom questionnaire twice daily were eligible.
No employee developed symptomatic EVD or LF. EVD and LF antibody studies were performed on sera samples from 42 HCP. The 6 participants who had received investigational vaccination with a chimpanzee adenovirus type 3 vectored Ebola glycoprotein vaccine had high antibody titers to Ebola glycoprotein, but none had a response to Ebola nucleoprotein or VP40, or a response to LF antigens.
Patients infected with filoviruses and arenaviruses can be managed successfully without causing occupation-related symptomatic or asymptomatic infections. Meticulous attention to infection control and clinical biosafety practices by highly motivated, trained staff is critical to the safe care of patients with an infection from a special pathogen.
Coral reefs have experienced extensive degradation across the world over the last 50 years as a result of a variety of stressors operating at a range of spatial and temporal scales. In order to assess whether declines are continuing, or if reefs are recovering, detailed baseline information is required from across wide spatial scales. Unfortunately, for some regions this information is not readily available, making future reef trajectories difficult to determine. Here we characterized the current benthic community state for coral reefs in the Wakatobi region of Indonesia, one of the most biodiverse marine regions in the world. We surveyed 10 reef sites (5, 10 and 15 m depth) to explore spatial variation in coral reef benthic communities and provide a detailed baseline. Previous data (2002–2011) were available for coral, sponges, algae and soft coral at six of our study sites. Using this information, we determined if any changes had occurred in dominance of these benthic groups. We found that benthic assemblage composition differed significantly over relatively small spatial scales (2–10 km) and hard coral cover was highly variable, ranging from 7–48% (average 19.5% ± 1.5 SE). While coral cover appears to have declined at all sites where data were available since 2002, we found little evidence for widespread increases in other benthic groups or regime shifts. Our study provides a comprehensive baseline dataset for the region that can be used in the future to determine rates of change in benthic communities.
We have detected 27 new supernova remnants (SNRs) using a new data release of the GLEAM survey from the Murchison Widefield Array telescope, including the lowest surface brightness SNR ever detected, G 0.1 – 9.7. Our method uses spectral fitting to the radio continuum to derive spectral indices for 26/27 candidates, and our low-frequency observations probe a steeper spectrum population than previously discovered. None of the candidates have coincident WISE mid-IR emission, further showing that the emission is non-thermal. Using pulsar associations we derive physical properties for six candidate SNRs, finding G 0.1 – 9.7 may be younger than 10 kyr. Sixty per cent of the candidates subtend areas larger than 0.2 deg2 on the sky, compared to < 25% of previously detected SNRs. We also make the first detection of two SNRs in the Galactic longitude range 220°–240°.
This work makes available a further
of the GaLactic and Extragalactic All-sky Murchison Widefield Array (GLEAM) survey, covering half of the accessible galactic plane, across 20 frequency bands sampling 72–231 MHz, with resolution
. Unlike previous GLEAM data releases, we used multi-scale CLEAN to better deconvolve large-scale galactic structure. For the galactic longitude ranges
$345^\circ < l < 67^\circ$
$180^\circ < l < 240^\circ$
, we provide a compact source catalogue of 22 037 components selected from a 60-MHz bandwidth image centred at 200 MHz, with RMS noise
and position accuracy better than 2 arcsec. The catalogue has a completeness of 50% at
, and a reliability of 99.86%. It covers galactic latitudes
towards the galactic centre and
for other regions, and is available from Vizier; images covering
for all longitudes are made available on the GLEAM Virtual Observatory (VO).server and SkyView.
We examined the latest data release from the GaLactic and Extragalactic All-sky Murchison Widefield Array (GLEAM) survey covering 345° < l < 60° and 180° < l < 240°, using these data and that of the Widefield Infrared Survey Explorer to follow up proposed candidate Supernova Remnant (SNR) from other sources. Of the 101 candidates proposed in the region, we are able to definitively confirm ten as SNRs, tentatively confirm two as SNRs, and reclassify five as H ii regions. A further two are detectable in our images but difficult to classify; the remaining 82 are undetectable in these data. We also investigated the 18 unclassified Multi-Array Galactic Plane Imaging Survey (MAGPIS) candidate SNRs, newly confirming three as SNRs, reclassifying two as H ii regions, and exploring the unusual spectra and morphology of two others.
TwinsUK is the largest cohort of community-dwelling adult twins in the UK. The registry comprises over 14,000 volunteer twins (14,838 including mixed, single and triplets); it is predominantly female (82%) and middle-aged (mean age 59). In addition, over 1800 parents and siblings of twins are registered volunteers. During the last 27 years, TwinsUK has collected numerous questionnaire responses, physical/cognitive measures and biological measures on over 8500 subjects. Data were collected alongside four comprehensive phenotyping clinical visits to the Department of Twin Research and Genetic Epidemiology, King’s College London. Such collection methods have resulted in very detailed longitudinal clinical, biochemical, behavioral, dietary and socioeconomic cohort characterization; it provides a multidisciplinary platform for the study of complex disease during the adult life course, including the process of healthy aging. The major strength of TwinsUK is the availability of several ‘omic’ technologies for a range of sample types from participants, which includes genomewide scans of single-nucleotide variants, next-generation sequencing, metabolomic profiles, microbiomics, exome sequencing, epigenetic markers, gene expression arrays, RNA sequencing and telomere length measures. TwinsUK facilitates and actively encourages sharing the ‘TwinsUK’ resource with the scientific community — interested researchers may request data via the TwinsUK website (http://twinsuk.ac.uk/resources-for-researchers/access-our-data/) for their own use or future collaboration with the study team. In addition, further cohort data collection is planned via the Wellcome Open Research gateway (https://wellcomeopenresearch.org/gateways). The current article presents an up-to-date report on the application of technological advances, new study procedures in the cohort and future direction of TwinsUK.
Although chylothorax is an uncommon complication following paediatric cardiothoracic surgery, it has significant associated morbidities and increased in-hospital mortality, as well as results in higher costs. A lack of prospective evidence or consensus guidelines for management of chylothorax further hinders optimal management. The aim of this survey was to characterise variations in practice in the management of chylothorax and to identify areas for future research.
Materials and methods:
A descriptive, observational survey investigating conservative management practices of chylothorax was distributed internationally to health-care professionals in paediatric intensive care and cardiology units. The survey investigated five domains: the first providing general information about health-care professionals and four domains focusing on clinical practice including diet composition and duration.
In total, sixty-four health-care professionals completed the survey, representing 38 organisations from 16 countries. The respondents were dietitians (80%), physicians (19%), and nurses (1%). In Australia and New Zealand, management was most commonly directed by physicians’ preference (67%) as compared to unit protocols in Europe (67%), United States of America (67%), and Other regions (55%). Dietitians in Australia/New Zealand, United Kingdom, and Ireland followed the most restrictive diet therapy recommending <5 g long chain triglyceride fat per day (p < 0.00001). The duration of diet therapy significantly varied between regions: Australia/New Zealand: 4 weeks (36%) and 6 weeks (43%); Europe: 4 weeks (25%) and 6 weeks (57%); and North America: 4 weeks (18%) and 6 weeks (75%) (p < 0.00001).
This survey highlights international variations in practice in the management of chylothorax, particularly with respect to treatment duration and dietary fat restriction. Future research should include a multi-centre randomised controlled trial to inform evidence-based practice and reduce morbidity, particularly poor growth.
We have observed the G23 field of the Galaxy AndMass Assembly (GAMA) survey using the Australian Square Kilometre Array Pathfinder (ASKAP) in its commissioning phase to validate the performance of the telescope and to characterise the detected galaxy populations. This observation covers ~48 deg2 with synthesised beam of 32.7 arcsec by 17.8 arcsec at 936MHz, and ~39 deg2 with synthesised beam of 15.8 arcsec by 12.0 arcsec at 1320MHz. At both frequencies, the root-mean-square (r.m.s.) noise is ~0.1 mJy/beam. We combine these radio observations with the GAMA galaxy data, which includes spectroscopy of galaxies that are i-band selected with a magnitude limit of 19.2. Wide-field Infrared Survey Explorer (WISE) infrared (IR) photometry is used to determine which galaxies host an active galactic nucleus (AGN). In properties including source counts, mass distributions, and IR versus radio luminosity relation, the ASKAP-detected radio sources behave as expected. Radio galaxies have higher stellar mass and luminosity in IR, optical, and UV than other galaxies. We apply optical and IR AGN diagnostics and find that they disagree for ~30% of the galaxies in our sample. We suggest possible causes for the disagreement. Some cases can be explained by optical extinction of the AGN, but for more than half of the cases we do not find a clear explanation. Radio sources aremore likely (~6%) to have an AGN than radio quiet galaxies (~1%), but the majority of AGN are not detected in radio at this sensitivity.
The current study examined whether self-reported memory problems among cognitively intact older adults changed concurrently with, preceded, or followed depressive symptoms over time.
Data were collected annually via in-person comprehensive medical and neuropsychological examinations as part of the Einstein Aging Study.
Community-dwelling older adults in an urban, multi-ethnic area of New York City were interviewed.
The current study included a total of 1,162 older adults (Mage = 77.65, SD = 5.03, 63.39% female; 74.12% White). Data were utilized from up to 11 annual waves per participant.
Multilevel modeling tested concurrent and lagged associations between three types of memory self-report (frequency of memory problems, perceived one-year decline, and perceived ten-year decline) and depressive symptoms.
Results showed that self-reported frequency of memory problems covaried with depressive symptoms only in participants who were older at baseline. Changes in perceived one-year and ten-year memory decline were related to changes in depressive symptoms across all ages. Depressive symptoms increased the likelihood of perceived ten-year memory decline the next year; however, perceived ten-year memory decline did not predict future depressive symptoms. Additionally, no significant temporal relationship was observed between depressive symptoms and self-reported frequency of memory problems or perceived one-year memory decline.
Our findings highlight the importance of testing the unique associations of different types of self-reported memory problems with depressive symptoms.
Previous research has described the evil eye as a source of illness for pregnant women and their newborns. This study sought to explore the perceptions of the evil eye among mothers whose newborns had experienced a life-threatening complication across three regions of Ghana. As part of a larger, quantitative study, trained research assistants identified pregnant and newly delivered women (and their newborns) who had survived a life-threatening complication at three tertiary care hospitals in southern Ghana to participate in open-ended, qualitative interviews about their experiences in March–August 2015. All interviews were audio-recorded and transcribed verbatim into English and analysis using the constant comparative method of theme generation. A total of 37 mothers were interviewed, 20 about neonatal illnesses and 17 about maternal illnesses. Six of the 20 mothers interviewed about their newborn’s illnesses spoke at length about the evil eye being a potential cause of newborn illness. The evil eye was described in a variety of terms, but commonalities included a person looking at a pregnant woman, her newborn baby, the baby’s clothes and even the mother’s food, causing harm, even unintentionally. Prevention required mothers covering themselves while pregnant and keeping the baby away from others until it was old enough to ward off the evil eye. Treatment required traditional medicine, yet some indicated that allopathic medicine could help. The evil eye appears to serve a social control mechanism, encouraging pregnant women to dress modestly, stay indoors as much as possible and behave appropriately. The evil eye is a pervasive, universally understood phenomenon across three regions of Ghana, even amongst a hospitalized population receiving allopathic health care for life-threatening complications of childbirth. Understanding the role of the evil eye in newborn illness attribution is important for clinicians, researchers and programmatic staff to effectively address barriers to care seeking.
Globally, grandparents are the main informal childcare providers with one-quarter of children aged ≤5 years regularly cared for by grandparents in Australia, the UK and USA. Research is conflicting; many studies claim grandparents provide excessive amounts of discretionary foods (e.g. high in fat/sugar/sodium) while others suggest grandparents can positively influence children’s diet behaviours. The present study aimed to explore the meaning and role of food treats among grandparents who provide regular informal care of young grandchildren.
Qualitative methodology utilising a grounded theory approach. Data were collected using semi-structured interviews and focus groups, then thematically analysed.
Participants were recruited through libraries, churches and playgroups in South Australia.
Grandparents (n 12) caring for grandchild/ren aged 1–5 years for 10 h/week or more.
Three themes emerged: (i) the functional role of treats (e.g. to reward good behaviour); (ii) grandparent role, responsibility and identity (e.g. the belief that grandparent and parent roles differ); and (iii) the rules regarding food treats (e.g. negotiating differences between own and parental rules). Grandparents favoured core-food over discretionary-food treats. They considered the risks (e.g. dental caries) and rewards (e.g. pleasure) of food treats and balanced their wishes with those of their grandchildren and parents.
Food treats play an important role in the grandparent–grandchild relationship and are used judiciously by grandparents to differentiate their identity and relationship from parents and other family members. This research offers an alternative narrative to the dominant discourse regarding grandparents spoiling grandchildren with excessive amounts of discretionary foods.
We explored how positive and negative life experiences of caregivers are associated with household food insecurity.
The Midlands Family Study (MFS) was a cross-sectional study with three levels of household food security: food secure, food insecure without child hunger and food insecure with child hunger. Ordinal logistic regression analysis was used for analyses of negative and positive life experiences (number, impact, type) associated with food insecurity.
An eight-county region in South Carolina, USA, in 2012–2013.
Caregivers (n 511) in households with children.
Caregivers who reported greater numbers of negative life experiences and greater perceived impact had increased odds of household food insecurity and reporting their children experienced hunger. Each additional negative life experience count of the caregiver was associated with a 16 % greater odds of food insecurity without child hunger and a 28 % greater odds of child hunger. Each one-unit increase in the negative impact score (e.g. a worsening) was associated with 8 % higher odds of food insecurity without child hunger and 12 % higher odds of child hunger. Negative work experiences or financial instability had the strongest association (OR = 1·8; 95 % CI 1·5, 2·2) with child hunger. Positive life experiences were generally not associated with food security status, with one exception: for each unit increase in the number of positive experiences involving family and other relationships, the odds of child hunger decreased by 22 %.
More research is needed to understand approaches to build resilience against negative life experiences and strengthen positive familial, community and social relationships.
Three-dimensional numerical simulations of canonical statistically steady, statistically planar turbulent flames have been used in an attempt to produce distributed burning in lean methane and hydrogen flames. Dilatation across the flame means that extremely large Karlovitz numbers are required; even at the extreme levels of turbulence studied (up to a Karlovitz number of 8767) distributed burning was only achieved in the hydrogen case. In this case, turbulence was found to broaden the reaction zone visually by around an order of magnitude, and thermodiffusive effects (typically present for lean hydrogen flames) were not observed. In the preheat zone, the species compositions differ considerably from those of one-dimensional flames based a number of different transport models (mixture averaged, unity Lewis number and a turbulent eddy viscosity model). The behaviour is a characteristic of turbulence dominating non-unity Lewis number species transport, and the distinct limit is again attributed to dilatation and its effect on the turbulence. Peak local reaction rates are found to be lower in the distributed case than in the lower Karlovitz cases but higher than in the laminar flame, which is attributed to effects that arise from the modified fuel-temperature distribution that results from turbulent mixing dominating low Lewis number thermodiffusive effects. Finally, approaches to achieve distributed burning at realisable conditions are discussed; factors that increase the likelihood of realising distributed burning are higher pressure, lower equivalence ratio, higher Lewis number and lower reactant temperature.
Salmonella enterica serovar Wangata (S. Wangata) is an important cause of endemic salmonellosis in Australia, with human infections occurring from undefined sources. This investigation sought to examine possible environmental and zoonotic sources for human infections with S. Wangata in north-eastern New South Wales (NSW), Australia. The investigation adopted a One Health approach and was comprised of three complimentary components: a case–control study examining human risk factors; environmental and animal sampling; and genomic analysis of human, animal and environmental isolates. Forty-eight human S. Wangata cases were interviewed during a 6-month period from November 2016 to April 2017, together with 55 Salmonella Typhimurium (S. Typhimurium) controls and 130 neighbourhood controls. Indirect contact with bats/flying foxes (S. Typhimurium controls (adjusted odds ratio (aOR) 2.63, 95% confidence interval (CI) 1.06–6.48)) (neighbourhood controls (aOR 8.33, 95% CI 2.58–26.83)), wild frogs (aOR 3.65, 95% CI 1.32–10.07) and wild birds (aOR 6.93, 95% CI 2.29–21.00) were statistically associated with illness in multivariable analyses. S. Wangata was detected in dog faeces, wildlife scats and a compost specimen collected from the outdoor environments of cases’ residences. In addition, S. Wangata was detected in the faeces of wild birds and sea turtles in the investigation area. Genomic analysis revealed that S. Wangata isolates were relatively clonal. Our findings suggest that S. Wangata is present in the environment and may have a reservoir in wildlife populations in north-eastern NSW. Further investigation is required to better understand the occurrence of Salmonella in wildlife groups and to identify possible transmission pathways for human infections.
The aim of this study was to examine the extent to which an exposure to disaster is associated with change in health behaviors.
Federal disaster declarations were matched at the county-level to self-reported behaviors for participants in the Health and Retirement Study (HRS), 2000-2014. Multivariable logistic regression was used to evaluate the relationship between disaster and change in physical activity, body mass index (BMI), and cigarette smoking.
The sample included 20,671 individuals and 59,450 interviews; 1,451 unique disasters were declared in counties in which HRS respondents lived during the study period. Exposure to disaster was significantly associated with weight gain (unadjusted RRR=1.19; 95% CI, 1.11-1.27; adjusted RRR=1.21; 95% CI, 1.13-1.30). Vigorous physical activity was significantly lower among those who had experienced a disaster compared to those who had not (unadjusted OR=0.89; 95% CI, 0.84-0.95; adjusted OR=0.84; 95% CI, 0.79-0.89). No significant difference in cigarette smoking was found.
This study found an increase in weight gain and decrease in physical activity among older adults after disaster exposure. Adverse health behaviors such as these can contribute to functional decline among older adults.
BellSA, ChoiH, LangaKM, IwashynaTJ. Health Risk Behaviors after Disaster Exposure Among Older Adults. Prehosp Disaster Med. 2019;34(1):95–97.
The extent to which exposure to childhood sexual and physical abuse increases the risk of psychotic experiences in adulthood is currently unclear.
To examine the relationship between childhood sexual and physical abuse and psychotic experiences in adulthood taking into account potential confounding and time-dynamic covariate factors.
Data were from a cohort of 1265 participants studied from birth to 35 years. At ages 18 and 21, cohort members were questioned about childhood sexual and physical abuse. At ages 30 and 35, they were questioned about psychotic experiences (symptoms of abnormal thought and perception). Generalised estimating equation models investigated covariation of the association between abuse exposure and psychotic experiences including potential confounding factors in childhood (socioeconomic disadvantage, adverse family functioning) and time-dynamic covariate factors (mental health, substance use and life stress).
Data were available for 962 participants; 6.3% had been exposed to severe sexual abuse and 6.4% to severe physical abuse in childhood. After adjustment for confounding and time-dynamic covariate factors, those exposed to severe sexual abuse had rates of abnormal thought and abnormal perception symptoms that were 2.25 and 4.08 times higher, respectively than the ‘no exposure’ group. There were no significant associations between exposure to severe physical abuse and psychotic experiences.
Findings indicate that exposure to severe childhood sexual (but not physical) abuse is independently associated with an increased risk of psychotic experiences in adulthood (particularly symptoms of abnormal perception) and this association could not be fully accounted for by confounding or time-dynamic covariate factors.
Mesophotic ecosystems have been relatively poorly studied in the Indo-Pacific and in particular within the Coral Triangle region. Here we used a mini-ROV to explore the changes in major benthic groups at two sites (~200 m apart) in the Wakatobi Marine National Park, SE Sulawesi, Indonesia spanning shallow water coral reefs (5 m) to deeper water mesophotic ecosystems (80 m). We found very similar patterns at both sites where coral cover peaked at 15 m, declined rapidly by 30 m, and was virtually absent at 50 m. As coral declined there was a marked increase in sponges, soft corals and other encrusting organisms (including ascidians, bryozoans, tubeworms, gorgonians and molluscs). Importantly, our results differ from most previous studies in other geographic locations where hard corals extend much deeper. It is unclear what drives this difference but it may be related to higher levels of turbidity and therefore reduced light penetration in the Wakatobi compared with other areas, which limits the vertical extent of coral development.
Natural disasters are increasing in frequency and severity. They cause widespread hardship and are associated with detrimental effects on mental health.
Our aim is to provide the best estimate of the effects of natural disasters on mental health through a systematic review and meta-analysis of the rates of psychological distress and psychiatric disorder after natural disasters.
This systematic review and meta-analysis is limited to studies that met predetermined quality criteria. We required included studies to make comparisons with pre-disaster or non-disaster exposed controls, and sample representative populations. Key studies were identified through a comprehensive search of PubMed, EMBASE and PsycINFO from 1980 to 3 March 2017. Random effects meta-analyses were performed for studies that reported key outcomes with appropriate statistics.
Forty-one studies were identified by the literature search, of which 27 contributed to the meta-analyses. Continuous measures of psychological distress were increased after natural disasters (combined standardised mean difference 0.63, 95% CI 0.27–0.98, P = 0.005). Psychiatric disorders were also increased (combined odds ratio 1.84, 95% CI 1.43–2.38, P < 0.001). Rates of post-traumatic stress disorder and depression were significantly increased after disasters. Findings for anxiety and alcohol misuse/dependence were not significant. High rates of heterogeneity suggest that disaster-specific factors and, to a lesser degree, methodological factors contribute to the variance between studies.
Increased rates of psychological distress and psychiatric disorders follow natural disasters. High levels of heterogeneity between studies suggest that disaster variables and post-disaster response have the potential to mitigate adverse effects.