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Poor physical health in severe mental illness (SMI) remains a major issue for clinical practice.
To use electronic health records of routinely collected clinical data to determine levels of screening for cardiometabolic disease and adverse health outcomes in a large sample (n = 7718) of patients with SMI, predominantly schizophrenia and bipolar disorder.
We linked data from the Glasgow Psychosis Clinical Information System (PsyCIS) to morbidity records, routine blood results and prescribing data.
There was no record of routine blood monitoring during the preceding 2 years for 16.9% of the cohort. However, monitoring was poorer for male patients, younger patients aged 16–44, those with schizophrenia, and for tests of cholesterol, triglyceride and glycosylated haemoglobin. We estimated that 8.0% of participants had diabetes and that lipids levels, and use of lipid-lowering medication, was generally high.
Electronic record linkage identified poor health screening and adverse health outcomes in this vulnerable patient group. This approach can inform the design of future interventions and health policy.
This study originated in collaboration with Thomas Dishion because of concerns that a group format for aggressive children might dampen the effects of cognitive-behavioral intervention. Three hundred sixty aggressive preadolescent children were screened through teacher and parent ratings. Schools were randomized to receive either an individual or a group format of the child component of the same evidence-based program. The results indicate that there is variability in how group-based cognitive-behavioral intervention can affect aggressive children through a long 4-year follow-up after the end of the intervention. Aggressive children who have higher skin conductance reactivity (potentially an indicator of poorer emotion regulation) and who have a variant of the oxytocin receptor gene that may be associated with being hyperinvolved in social bonding have better outcomes in their teacher-rated externalizing behavior outcomes over time if they were seen individually rather than in groups. Analyses also indicated that higher levels of the group leaders’ clinical skills predicted reduced externalizing behavior problems. Implications for group versus individual format of cognitive-behavioral interventions for aggressive children, and for intensive training for group therapists, informed by these results, are discussed.
This study evaluated the efficacy of a family-centered preventive intervention, the Family Check-Up (FCU), delivered as an online, eHealth model to middle school families. To increase accessibility of family-centered prevention in schools, we adapted the evidence-based FCU to an online format, with the goal of providing a model of service delivery that is feasible, given limited staffing and resources in many schools. Building on prior research, we randomly assigned participants to waitlist control (n = 105), FCU Online as a web-based intervention (n = 109), and FCU Online with coaching support (n = 108). We tested the effects of the intervention on multiple outcomes, including parental self-efficacy, child self-regulation, and child behavior, in this registered clinical trial (NCT03060291). Families engaged in the intervention at a high rate (72% completed the FCU assessment) and completed 3-month posttest assessments with good retention (94% retained). Random assignment to the FCU Online with coaching support was associated with reduced emotional problems for children (p = .003, d = −0.32) and improved parental confidence and self-efficacy (p = .018, d = 0.25) when compared with waitlist controls. Risk moderated effects: at-risk youth showed stronger effects than did those with minimal risk. The results have implications for online delivery of family-centered interventions in schools.
Building on prior work using Tom Dishion's Family Check-Up, the current article examined intervention effects on dysregulated irritability in early childhood. Dysregulated irritability, defined as reactive and intense response to frustration, and prolonged angry mood, is an ideal marker of neurodevelopmental vulnerability to later psychopathology because it is a transdiagnostic indicator of decrements in self-regulation that are measurable in the first years of life that have lifelong implications for health and disease. This study is perhaps the first randomized trial to examine the direct effects of an evidence- and family-based intervention, the Family Check-Up (FCU), on irritability in early childhood and the effects of reductions in irritability on later risk of child internalizing and externalizing symptomatology. Data from the geographically and sociodemographically diverse multisite Early Steps randomized prevention trial were used. Path modeling revealed intervention effects on irritability at age 4, which predicted lower externalizing and internalizing symptoms at age 10.5. Results indicate that family-based programs initiated in early childhood can reduce early childhood irritability and later risk for psychopathology. This holds promise for earlier identification and prevention approaches that target transdiagnostic pathways. Implications for future basic and prevention research are discussed.
To assess if there is a difference in salt intake (24 h urine collection and dietary recall) and dietary sources of salt (Na) on weekdays and weekend days.
A cross-sectional study of adults who provided one 24 h urine collection and one telephone-administered 24 h dietary recall.
Community-dwelling adults living in the State of Victoria, Australia.
Adults (n 598) who participated in a health survey (53·5 % women; mean age 57·1 (95 % CI 56·2, 58·1) years).
Mean (95 % CI) salt intake (dietary recall) was 6·8 (6·6, 7·1) g/d and 24 h urinary salt excretion was 8·1 (7·8, 8·3) g/d. Mean dietary and 24 h urinary salt (age-adjusted) were 0·9 (0·1, 1·6) g/d (P=0·024) and 0·8 (0·3, 1·6) g/d (P=0·0017), respectively, higher at weekends compared with weekdays. There was an indication of a greater energy intake at weekends (+0·6 (0·02, 1·2) MJ/d, P=0·06), but no difference in Na density (weekday: 291 (279, 304) mg/MJ; weekend: 304 (281, 327) mg/MJ; P=0·360). Cereals/cereal products and dishes, meat, poultry, milk products and gravy/sauces accounted for 71 % of dietary Na.
Mean salt intake (24 h urine collection) was more than 60 % above the recommended level of 5 g salt/d and 8–14 % more salt was consumed at weekends than on weekdays. Substantial reductions in the Na content of staple foods, processed meat, sauces, mixed dishes (e.g. pasta), convenience and takeaway foods are required to achieve a significant consistent reduction in population salt intake throughout the week.
Fatigue cracking in polycrystalline NiTi was investigated using a multiscale experimental framework for average grain sizes (GS) from 10 to 1500 nm for the first time. Macroscopic fatigue crack growth rates, measured by optical digital image correlation, were connected to microscopic crack opening and closing displacements, measured by scanning electron microscope DIC (SEM-DIC) using a high-precision external SEM scan controller. Among all grain sizes, the 1500 nm GS sample exhibited the slowest crack growth rate at the macroscale, and the largest crack opening level (stress intensity at first crack opening) and minimum crack opening displacements at the microscale. Smaller GS samples (10, 18, 42, and 80 nm) exhibited nonmonotonic trends in their fatigue performance, yet the correlation was strong between macroscale and microscale behaviors for each GS. The samples that exhibited the fastest crack growth rates (42 and 80 nm GS) showed a small crack opening level and the largest crack opening displacements. The irregular trends in fatigue performance across the nanocrystalline GS samples were consistent with nonmonotonic values in the elastic modulus reported previously, both of which may be related to the presence of residual martensite only evident in the small GS samples (10 and 18 nm).
We analyse the displacement of one fluid by a second immiscible fluid through a narrow channel of finite length which connects two reservoirs. We assume that the channel width slowly decreases in the direction of flow, and that the fluids have different viscosity and density. We examine the stability of the interface and find that there are Saffman–Taylor and Rayleigh–Taylor type modes, which may dominate in the narrow and wide regions of the channel, respectively. The gradient of the pressure jump across the interface associated with the surface tension acts to stabilise the interface, and for intermediate channel widths, this effect may dominate the destabilisation associated with both the Rayleigh–Taylor and Saffman–Taylor instabilities, provided the rate of change of the channel width with distance along the channel is sufficient. We also note that the effect of the converging channel leads to instability of long-wavelength modes owing to the quasi-static acceleration of the flow through the cell: we consider cases in which this effect only occurs at much lower wavenumbers than the most unstable Saffman–Taylor and Rayleigh–Taylor modes. We show that there is a maximum wavenumber for instability, which varies with position in the channel. By integrating the growth rate of each wavenumber in time as the interface moves across the channel, we predict the mode which grows to the greatest amplitude as the interface traverses the channel.
This study details the characterization of a glass sample exposed to hyperalkaline water and calcium-rich sediment for an extended time period (estimated as 2 - 70 years) at a lime (CaO) waste site in the UK. We introduce this site, known as Peak Dale, in reference to its use as a natural analogue for nuclear waste glass dissolution in the high pH environment of a cementitious engineered barrier of a geological disposal facility. In particular, a preliminary assessment of alteration layer chemistry and morphology is described and the initiation of a long-term durability assessment is outlined.
Excavations at the Middle Pleistocene site of La Cotte de St Brelade, on the
island of Jersey in the English Channel, have revealed a long sequence of
occupation. The continued use of the site by Neanderthals throughout an
extended period of changing climate and environment reveals how, despite
changes in the types of behaviour recorded at the site, La Cotte emerged as
a persistent place in the memory and landscape of its early hominin
inhabitants. The site's status as a persistent place for these people
suggests a level of social and cognitive development permitting reference to
and knowledge of places distant in time and space as long ago as at least
Advanced machine learning techniques like Gaussian process regression and multi-task learning are novel in the area of wine price prediction; previous research in this area being restricted to parametric linear regression models when predicting wine prices. Using historical price data of the 100 wines in the Liv-Ex 100 index, the main contributions of this paper to the field are, firstly, a clustering of the wines into two distinct clusters based on autocorrelation. Secondly, an implementation of Gaussian process regression on these wines with predictive accuracy surpassing both the trivial and simple ARMA and GARCH time series prediction benchmarks. Lastly, an implementation of an algorithm which performs multi-task feature learning with kernels on the wine returns as an extension to our optimal Gaussian process regression model. Using the optimal covariance kernel from Gaussian process regression, we achieve predictive results which are comparable to that of Gaussian process regression. Altogether, our research suggests that there is potential in using advanced machine learning techniques in wine price prediction. (JEL Classifications: C6, G12)
We analyzed the recent (< 25 yr) spread in New Hampshire, USA, of the exotic tree Kalopanax septemlobus, native to Asia. The invasion was likely initiated by a single tree planted ca. 1972. Our objective was to assess the viability of the invasion, especially in light of the small propagule size. We tallied, mapped, aged, and measured the height and growth of K. septemlobus individuals at two sites, the University of New Hampshire campus (UC) and Thompson Farm (TF), both in Durham. We found over 3,800 plants at UC and 270 at TF in < 120 ha (296 ac) total area. Plant age ranged from 0 to 22 yr, and UC plants were as far as 775 m (2,543 ft) from the purported parent tree. Annual height growth was comparable to midtolerant native trees. Plants occurred in both open and forested habitats, and the mean level of photosynthetically active radiation incident on understory plants was 4 to 6% of full sun. The large population size, shade tolerance, rapid height growth, and ability to sprout from damaged stems suggest potential for K. septemlobus to invade and persist in forests, the most common natural ecosystem in the northeastern United States. We further suggest that small propagule size, likely a single tree, has not prevented K. septemlobus from initiating a spatially extensive and vigorous population. Kalopanax septemlobus has been planted as an ornamental in the northeastern United States, and prevention of region-wide invasion might depend on removal of these trees, even when they occur as single individuals.