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This study investigates suicide risk in late childhood and early adolescence in relation to a family-centered intervention, the Family Check-Up, for problem behavior delivered in early childhood. At age 2, 731 low-income families receiving nutritional services from Women, Infants, and Children programs were randomized to the Family Check-Up intervention or to a control group. Trend-level main effects were observed on endorsement of suicide risk by parents or teachers from ages 7.5 to 14, with higher rates of suicide risk endorsement in youth in the control versus intervention condition. A significant indirect effect of intervention was also observed, with treatment-related improvements in inhibitory control across childhood predicting reductions in suicide-related risk both at age 10.5, assessed via diagnostic interviews with parents and youth, and at age 14, assessed via parent and teacher reports. Results add to the emerging body of work demonstrating long-term reductions in suicide risk related to family-focused preventive interventions, and highlight improvements in youth self-regulatory skills as an important mechanism of such reductions in risk.
Strangely enough, no one has noticed in the life of Niccolò Machiavelli a pattern of engagement with Franciscans. Machiavelli's writings mark a significant shift in the development of Western ideas concerning happiness. It helps us better to understand this shift if we realize that an important part of what Machiavelli proposed was developed in opposition to teachings that were emphasized two centuries earlier by St. Francis of Assisi and that remained influential in Machiavelli's own day.
We can perhaps best illustrate the manner in which Machiavelli responded to the poverello from Assisi by looking at a dramatic passage in the Little Flowers of Saint Francis, a popular collection of stories concerning Francis that was composed in the late fourteenth century and circulated widely in Machiavelli's time – as it still does today. The author of the Little Flowers writes,
One day in winter, as St Francis was going with Brother Leo from Perugia to St Mary of the Angels, and was suffering greatly from the cold, he called to Brother Leo, who was walking on before him, and said to him: ‘Brother Leo, if it were to please God that the Friars Minor should give, in all lands, a great example of holiness and edification, write down, and note carefully, that this would not be perfect joy (letizia)’.
A little further on, St Francis called to him a second time: ‘O Brother Leo, if the Friars Minor were to make the lame to walk, if they should make straight the crooked, chase away demons, give sight to the blind, hearing to the deaf, speech to the dumb, and, what is even a far greater work, if they should raise the dead after four days, write that this would not be perfect joy’.
Shortly after, he cried out again: ‘O Brother Leo, if the Friars Minor knew all languages; if they were versed in all science; if they could explain all Scripture; if they had the gift of prophecy, and could reveal, not only all future things, but likewise the secrets of all consciences and all souls, write that this would not be perfect joy’.
Recent infection testing algorithms (RITA) for HIV combine serological assays with epidemiological data to determine likely recent infections, indicators of ongoing transmission. In 2016, we integrated RITA into national HIV surveillance in Ireland to better inform HIV prevention interventions. We determined the avidity index (AI) of new HIV diagnoses and linked the results with data captured in the national infectious disease reporting system. RITA classified a diagnosis as recent based on an AI < 1.5, unless epidemiological criteria (CD4 count <200 cells/mm3; viral load <400 copies/ml; the presence of AIDS-defining illness; prior antiretroviral therapy use) indicated a potential false-recent result. Of 508 diagnoses in 2016, we linked 448 (88.1%) to an avidity test result. RITA classified 12.5% of diagnoses as recent, with the highest proportion (26.3%) amongst people who inject drugs. On multivariable logistic regression recent infection was more likely with a concurrent sexually transmitted infection (aOR 2.59; 95% CI 1.04–6.45). Data were incomplete for at least one RITA criterion in 48% of cases. The study demonstrated the feasibility of integrating RITA into routine surveillance and showed some ongoing HIV transmission. To improve the interpretation of RITA, further efforts are required to improve completeness of the required epidemiological data.
Psychotic experiences (PEs), including hallucination- and delusion-like experiences, are robustly associated with self-injurious thoughts and behaviours (SITB) in the general population. However, it remains unclear as to why there is an association. The purpose of this systematic review was to elucidate the role of other factors that influence the association between PEs and SITB and, in doing so, highlight potential mechanisms underlying the relationship. A search of electronic international databases was undertaken, including PubMed, PsycINFO and EMBASE, and eligible studies were grouped according to seven confounder categories: sociodemographics, mental disorders, alcohol and substance use, environmental, psychological, intervention and family history/genetic factors. The systematic search strategy identified 41 publications reporting on 1 39 427 participants from 16 different countries. In the majority of studies, where adjustment for other variables occurred, the association between PEs and SITB persisted, suggesting PEs have an independent role. Common mental disorders, psychological distress and negative environmental exposures explained a substantial amount of the variance and therefore need to be considered as potential underlying mechanisms. There was high variability in the variables adjusted for in these studies, and so the question still remains as to whether the association between PEs and self-harm/suicidality can be attributed (fully or in part) to confounding and mediating factors or directly causal mechanisms. Regardless of causality, the now extensive literature reporting an association between these two clinical phenomena supports the broad usefulness of PEs as an indicator of risk for SITB.
The UK has one of the largest systems of immigration detention in Europe.. Those detained include asylum-seekers and foreign national prisoners, groups with a higher prevalence of mental health vulnerabilities compared with the general population. In light of little published research on the mental health status of detainees in immigration removal centres (IRCs), the primary aim of this study was to explore whether it was feasible to conduct psychiatric research in such a setting. A secondary aim was to compare the mental health of those seeking asylum with the rest of the detainees.
Cross-sectional study with simple random sampling followed by opportunistic sampling. Exclusion criteria included inadequate knowledge of English and European Union nationality. Six validated tools were used to screen for mental health disorders including developmental disorders like Personality Disorder, Attention Deficit Hyperactivity Disorder (ADHD), Autistic Spectrum Disorder (ASD) and Intellectual Disability, as well as for needs assessment. These were the MINI v6, SAPAS, AQ-10, ASRS, LDSQ and CANFOR. Demographic data were obtained using a participant demographic sheet. Researchers were trained in the use of the screening battery and inter-rater reliability assessed by joint ratings.
A total of 101 subjects were interviewed. Overall response rate was 39%. The most prevalent screened mental disorder was depression (52.5%), followed by personality disorder (34.7%) and post-traumatic stress disorder (20.8%). 21.8% were at moderate to high suicidal risk. 14.9 and 13.9% screened positive for ASD and ADHD, respectively. The greatest unmet needs were in the areas of intimate relationships (76.2%), psychological distress (72.3%) and sexual expression (71.3%). Overall presence of mental disorder was comparable with levels found in prisons. The numbers in each group were too small to carry out any further analysis.
It is feasible to undertake a psychiatric morbidity survey in an IRC. Limitations of the study include potential selection bias, use of screening tools, use of single-site study, high refusal rates, the lack of interpreters and lack of women and children in study sample. Future studies should involve the in-reach team to recruit participants and should be run by a steering group consisting of clinicians from the IRC as well as academics.
Let's begin by presenting some newly discovered documents concerning Niccolò Machiavelli. The biographical detail may at first appear overwhelming, but the light these documents shed on the chronology of Machiavelli's composition of The Prince helps to answer some old questions concerning the character of Machiavelli's little treatise. The new documents date from the year 1515. They were drawn up at a time of financial difficulty and profound personal disappointment in the life of the former Florentine secretary and second chancellor. In 1512 Machiavelli had been fired from the chancery of the Florentine Republic. In 1513 he had been arrested on a probably false charge of conspiracy, tortured (although he gave no confession), and then unexpectedly freed in a general amnesty following the election of a Florentine, Giovanni de' Medici, as Pope Leo X. In 1515, at the time these documents were drawn up, Machiavelli was still out of favor. But he was also putting into prose the theoretical work that established the extraordinary reputation still associated with him today.
Human leptospirosis is found throughout the world, albeit with a higher incidence in tropical regions. In temperate regions it is associated with certain occupational and recreational activities. This paper reports both on the incidence of human leptospirosis in Ireland and on possible associated exposures, using leptospirosis case notification, enhanced surveillance, hospital discharge data and death registrations. Based on official notification data, there was a threefold increase in the reported incidence of leptospirosis in Ireland between 1995–1999 and 2004–2009, which appears partially to be due to improved reporting. The exposures most associated with infection were those involving contact with livestock or water-based recreational sports, in particular kayaking. Advice on prevention should continue to be targeted in the first instance at these groups. The variety of potential transmission routes reported should inform clinicians to consider leptospirosis in individuals with a compatible clinical profile who were not from occupational groups historically considered at risk.
The Ultra-Fast Flash Observatory (UFFO), which will be launched onboard the
Lomonosov spacecraft, contains two crucial instruments: UFFO Burst
Alert & Trigger Telescope (UBAT) for detection and localization of Gamma-Ray Bursts
(GRBs) and the fast-response Slewing Mirror Telescope (SMT) designed for the observation
of the prompt optical/UV counterparts. Here we discuss the in-space calibrations of the
UBAT detector and SMT telescope. After the launch, the observations of the standard X-ray
sources such as pulsar in Crab nebula will provide data for necessary calibrations of
UBAT. Several standard stars will be used for the photometric calibration of SMT. The
celestial X-ray sources, e.g. X-ray binaries with bright optical sources
in their close angular vicinity will serve for the cross-calibration of UBAT and SMT.
The Ultra-Fast Flash Observatory (UFFO) Pathfinder for Gamma-Ray Bursts (GRBs) consists
of two telescopes. The UFFO Burst Alert & Trigger Telescope (UBAT) handles the
detection and localization of GRBs, and the Slewing Mirror Telescope (SMT) conducts the
measurement of the UV/optical afterglow. UBAT is equipped with an X-ray detector, analog
and digital signal readout electronics that detects X-rays from GRBs and determines the
location. SMT is equipped with a stepping motor and the associated electronics to rotate
the slewing mirror targeting the GRBs identified by UBAT. First the slewing mirror points
to a GRB, then SMT obtains the optical image of the GRB using the intensified CCD and its
readout electronics. The UFFO Data Acquisition system (UDAQ) is responsible for the
overall function and operation of the observatory and the communication with the satellite
main processor. In this paper we present the design and implementation of the electronics
of UBAT and SMT as well as the architecture and implementation of UDAQ.
One of the unexplored domains in the study of gamma-ray bursts (GRBs) is the early time
phase of the optical light curve. We have proposed Ultra-Fast Flash Observatory (UFFO) to
address this question through extraordinary opportunities presented by a series of small
space missions. The UFFO is equipped with a fast-response Slewing Mirror Telescope that
uses a rapidly moving mirror or mirror array to redirect the optical beam rather than
slewing the entire spacecraft or telescope to aim the optical instrument at the GRB
position. The UFFO will probe the early optical rise of GRBs with sub-second response, for
the first time, opening a completely new frontier in GRB and transient studies. Its fast
response measurements of the optical emission of dozens of GRB each year will provide
unique probes of the burst mechanism and test the prospect of GRB as a new standard
candle, potentially opening up the z > 10 universe. We describe the current limit in
early photon measurements, the aspects of early photon physics, our soon-to-be-launched
UFFO-pathfinder mission, and our next planned mission, the UFFO-100.