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Internationally, intimate partner violence (IPV) cohorts have demonstrated associations with depression and anxiety. However, this association has not yet been described in a UK population, nor has the association with serious mental illness (SMI).
To explore the relationship between IPV exposure and mental illness in a UK population.
We designed a retrospective cohort study whereby we matched 18 547 women exposed to IPV to 74 188 unexposed women. Outcomes of interest (anxiety, depression and SMI) were identified through clinical codes.
At baseline, 9174 (49.5%) women in the exposed group had some form of mental illness compared with 17 768 (24.0%) in the unexposed group, described as an adjusted odds ratio of 2.62 (95% CI 2.52–2.72). Excluding those with mental illness at baseline, 1254 exposed women (incidence rate 46.62 per 1000 person-years) went on to present with any type of mental illness compared with 3119 unexposed women (incidence rate 14.93 per 1000 person-years), with an aIRR of 2.77 (95% CI 2.58–2.97). Anxiety (aIRR 1.99, 95% CI 1.80–2.20), depression (aIRR 3.05, 95% CI 2.81–3.31) and SMI (aIRR 3.08, 95% CI 2.19–4.32) were all associated with exposure to IPV.
IPV remains a significant public health issue in the UK. We have demonstrated the significant recorded mental health burden associated with IPV in primary care, at both baseline and following exposure. Clinicians must be aware of this association to reduce mental illness diagnostic delay and improve management of psychological outcomes in this group of patients.
More than 68 million people worldwide have been forcibly displaced and one-third of these are refugees. This article offers an overview of the current literature and reviews the epidemiology and evidence-based psychological and pharmacological management of post-traumatic stress disorder (PTSD), sleep disturbance and pain in refugees and asylum seekers. It also considers the relationship between sleep disturbance and PTSD and explores concepts of pain in relation to physical and psychological trauma and distress. During diagnosis, clinicians must be aware of ethnic variation in the somatic expression of distress. Treatments for PTSD, pain and sleep disturbance among refugees and asylum seekers are essentially the same as those used in the general population, but treatment strategies must allow for cultural and contextual factors, including language barriers, loss of freedom and threat of repatriation.
After reading this article you will be able to:
• recognise the challenges faced by the large number of refugees worldwide
• understand the relationship between PTSD, sleep disturbance and pain in refugees
• broadly understand the evidence for psychological and pharmacological therapy for treating PTSD, sleep disturbance and pain in refugees.
Decision-makers need readily accessible tools to understand the potential impacts of alternative policies on forest cover and greenhouse gas (GHG) emissions and to develop effective policies to meet national and international targets for biodiversity conservation, sustainable development and climate change mitigation. Land change modelling can support policy decisions by demonstrating potential impacts of policies on future deforestation and GHG emissions. We modelled land change to explore the potential impacts of expert-informed scenarios on deforestation and GHG emissions, specifically CO2 emissions, in the Ankeniheny–Zahamena Corridor in eastern Madagascar. We considered four scenarios: business as usual; effective conservation of protected areas; investment in infrastructure; and agricultural intensification. Our results highlight that effective forest conservation could deliver substantial emissions reductions, while infrastructure development will likely cause forest loss in new areas. Agricultural intensification could prevent additional forest loss if it reduced the need to clear more land while improving food security. Our study demonstrates how available land change modelling tools and scenario analyses can inform land-use policies, helping countries reconcile economic development with forest conservation and climate change mitigation commitments.
Objectives: Caregivers of youth with heavy prenatal alcohol exposure report impaired communication, which can significantly impact quality of life. Using data collected as part of the Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD), we examined whether cognitive variables predict communication ability of youth with histories of heavy prenatal alcohol exposure. Methods: Subjects (ages 10–16 years) comprised two groups: adolescents with heavy prenatal alcohol exposure (AE) and non-exposed controls (CON). Selected measures of executive function (NEPSY, Delis-Kaplan Executive Function System), working memory (CANTAB), and language were tested in the child, while parents completed communication ratings (Vineland Adaptive Behavior Scales – Second Edition). Separate multiple regression analyses determined which cognitive domains predicted communication ability. A final, global model of communication comprised the three cognitive models. Results: Spatial Working Memory and Inhibition significantly contributed to communication ability across groups. Twenty Questions performance related to communication ability in the CON group only while Word Generation performance related to communication ability in the AE group only. Effects remained significant in the global model, with the exception of Spatial Working Memory. Conclusions: Both groups displayed a relation between communication and Spatial Working Memory and Inhibition. Stronger communication ability related to stronger verbal fluency in the AE group and Twenty Questions performance in the CON group. These findings suggest that alcohol-exposed adolescents may rely more heavily on learned verbal storage or fluency for daily communication while non-exposed adolescents may rely more heavily on abstract thinking and verbal efficiency. Interventions aimed at aspects of executive function may be most effective at improving communication ability of these individuals. (JINS, 2018, 24, 1026–1037)
The NOVA food categorisation recommends ‘avoiding processed foods (PF), especially ultra-processed foods (UPF)’ and selecting minimally PF to address obesity and chronic disease. However, NOVA categories are drawn using non-traditional views of food processing with additional criteria including a number of ingredients, added sugars, and additives. Comparison of NOVA's definition and categorisation of PF with codified and published ones shows limited congruence with respect to either definition or food placement into categories. While NOVA studies associate PF with decreased nutrient density, other classifications find nutrient-dense foods at all levels of processing. Analyses of food intake data using NOVA show UPF provide much added sugars. Since added sugars are one criterion for designation as UPF, such a proof demonstrates a tautology. Avoidance of foods deemed as UPF, such as wholegrain/enriched bread and cereals or flavoured milk, may not address obesity but could decrease intakes of folate, calcium and dietary fibre. Consumer understanding and implementation of NOVA have not been tested. Neither have outcomes been compared with vetted patterns, such as Dietary Approaches to Stop Hypertension, which base food selection on food groups and nutrient contribution. NOVA fails to demonstrate the criteria required for dietary guidance: understandability, affordability, workability and practicality. Consumers’ confusion about definitions and food categorisations, inadequate cooking and meal planning skills and scarcity of resources (time, money), may impede adoption and success of NOVA. Research documenting that NOVA can be implemented by consumers and has nutrition and health outcomes equal to vetted patterns is needed.
Freshwater mussels are declining rapidly worldwide. Propagation has the potential to restore numbers of these remarkable organisms, preventing extinction of rare species and maintaining the many benefits that they bring to aquatic ecosystems. Written by practitioners with firsthand experience of propagation programs, this practical book is a thorough guide to the subject, taking readers through the process from start to finish. The latest propagation and culture techniques are explored as readers follow freshwater mussels through their amazing and complex life cycle. Topics covered include the basics of building a culture facility, collecting and maintaining brood stock, collecting host species, infesting host species with larval mussels, collecting and culturing juvenile mussels, releasing juveniles to the wild, and post-release monitoring. This will be valuable reading for any biologist interested in the conservation of freshwater mussel populations.
OBJECTIVES/SPECIFIC AIMS: The Institute for Transnational Sciences (ITS) has developed novel methods to ethically engage stakeholders across the transnational research spectrum, up to and including public health practice and policy. METHODS/STUDY POPULATION: In 2014, the ITS co-founded The Research, Education, And Community Health (REACH), the mission of which was to facilitate communication, collaborative research, and service activities between faculty and scientists and area community leaders. The intent was to identify and meet the needs of our communities without gaps and/or redundancies, thus better leveraging time, funding, and efforts. RESULTS/ANTICIPATED RESULTS: REACH now boasts 23 Centers, Departments, and Institutes, as well as 39 community organizations, including public and mental health agencies, clinicians, policy makers, family service centers, cultural and faith-based organizations, business, and local schools/colleges. We offer 3 methods for consideration as best practices: (1) a comprehensive community health needs assessment, (2) an “Offer and Ask” community/campus partnership mechanism, and (3) Community Science Workshops, based on the European Union’s Science Shops. DISCUSSION/SIGNIFICANCE OF IMPACT: Results of REACH’s work have been used to provide guidance for enhanced, data-driven programs and allocation of resources for local and statewide initiatives. The organization has evolved into an independent coalition seeking 501(c)3 status and is planning to expand its scope to 5 counties. REACH thus serves as model for successful replication across applicable CTSA hubs.
Severe mortality (93%) of overwintering larvae of emerald ash borer, Agrilus planipennis Fairmaire (Coleoptera: Buprestidae), was recorded in March 2016 from green ash, Fraxinus pennsylvanica Marshall (Oleaceae), in Syracuse, New York, United States of America. In contrast, larvae collected from the same area in January exhibited <1% mortality. A strong cold front moved across New York from 13 to 15 February 2016 with temperatures plunging to nearly −40 °C in some areas. In many regions of New York where A. planipennis is established, temperatures dropped well below the reported supercooling point of overwintering larvae. To evaluate whether the extreme cold was linked to extensive mortality of larvae, trees were sampled from four areas that experienced a gradient of minimum temperatures on 14 February 2016. Overwintering mortality varied from ⩽5% to 93% among regions, with lowest survival in the coldest regions. When excised from their galleries, dead larvae were discoloured with brown spots or had black necrotic tissue in the spiracles or foregut. This is the first report of extensive cold-related mortality for this species in North America and highlights the stochastic nature of climatic extremes on invasive species populations.