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Children of parents with mental disorder face multiple challenges.
To summarise evidence about parental mental disorder and child physical health.
We searched seven databases for cohort or case–control studies quantifying associations between parental mental disorders (substance use, psychotic, mood, anxiety, obsessive–compulsive, post-traumatic stress and eating) and offspring physical health. Studies were excluded if: they reported perinatal outcomes only (<28 days) or outcomes after age 18; they measured outcome prior to exposure; or the sample was drawn from diseased children. A meta-analysis was conducted. The protocol was registered on the PROSPERO database (CRD42017072620).
Searches revealed 15 945 non-duplicated studies. Forty-one studies met our inclusion criteria: ten investigated accidents/injuries; eight asthma; three other atopic diseases; ten overweight/obesity; ten studied other illnesses (eight from low-and middle-income countries (LMICs)). Half of the studies investigated maternal perinatal mental health, 17% investigated paternal mental disorder and 87% examined maternal depression. Meta-analysis revealed significantly higher rates of injuries (OR = 1.15, 95% CI 1.04–1.26), asthma (OR = 1.26, 95% CI 1.12–1.41) and outcomes recorded in LMICs (malnutrition: OR = 2.55, 95% CI 1.74–3.73; diarrhoea: OR = 2.16, 95% CI 1.65–2.84). Evidence was inconclusive for obesity and other atopic disorders.
Children of parents with mental disorder have health disadvantages; however, the evidence base is limited to risks for offspring following postnatal depression in mothers and there is little focus on fathers in the literature. Understanding the physical health risks of these vulnerable children is vital to improving lives. Future work should focus on discovering mechanisms linking physical and mental health across generations.
The lives of Children and Adolescents with PaRental mental Illness (CAPRI) represent a public health priority. Identifying those at most risk within the risk subset is crucial to promote resilience for this group. The ability to develop child-centred interventions will underpin the success of evidence-based services and CAPRI themselves are key to unlocking current service barriers.
Basic lead azides are obtained by the slow thermal decomposition of PbN6 at temperatures up to 200°C in oxygen, argon, and air containing varying amounts of moisture. The decomposition diagrams show several stages due to the formation of different phases, two of which have been separated. One phase can be identified as a tetragonal deformed cubic lattice. Further slow decompositions of the basic lead azide at 250°C lead to tetragonal lead oxide. The structure of the other isolated phase Is of lower symmetry and has not yet been classified. The results of this investigation are also compared with the work of previous investigators.
The goal of the occupational health professions is ”… to assure so far as possible every working man and woman in the Nation safe and healthful working conditions and to preserve our human resources” (Occupational Safety and Health Act, PL91-596). When the health of workers is threatened by chemical agents in the air, occupational health chemistry has a role to play. Analyses of workplace air are performed by the thousands each year by industry and by state and federal agencies. In the federal government, these analyses, as well as occupational health work in general, are performed by three agencies: the National Institute for Occupational Safety and Health (NIOSH, DHHS), which does occupational health research; the Occupational Safety and Health Administration (OSHA, DOL), which enforces safety and health standards in the general workplace; and the Mine Safety and Health Administration (MSHA, DOL), which enforces similar standards in mining operations.
Although disaster-related posttraumatic stress symptoms (PTSS) typically decrease in intensity over time, some youth continue to report elevated levels of PTSS many years after the disaster. The current study examines two processes that may help to explain the link between disaster exposure and enduring PTSS: caregiver emotion socialization and youth recollection qualities. One hundred and twenty-two youth (ages 12 to 17) and their female caregivers who experienced an EF-4 tornado co-reminisced about the event, and adolescents provided independent recollections between 3 and 4 years after the tornado. Adolescent individual transcripts were coded for coherence and negative personal impact, qualities that have been found to contribute to meaning making. Parent–adolescent conversations were coded for caregiver egocentrism, a construct derived from the emotion socialization literature to reflect the extent to which the caregiver centered the conversation on her own emotions and experiences. Egocentrism predicted higher youth PTSS, and this association was mediated by the coherence of adolescents’ narratives. The association between coherence and PTSS was stronger for youth who focused more on the negative personal impacts of the tornado event during their recollections. Results suggest that enduring tornado-related PTSS may be influenced in part by the interplay of caregiver emotion socialization practices and youth recollection qualities.
We present a theoretical framework for describing electromagnetic kinetic turbulence in a multi-species, magnetized, pressure-anisotropic plasma. The turbulent fluctuations are assumed to be small compared to the mean field, to be spatially anisotropic with respect to it and to have frequencies small compared to the ion cyclotron frequency. At scales above the ion-Larmor radius, the theory reduces to the pressure-anisotropic generalization of kinetic reduced magnetohydrodynamics (KRMHD) formulated by Kunz et al. (J. Plasma Phys., vol. 81, 2015, 325810501). At scales at and below the ion-Larmor radius, three main objectives are achieved. First, we analyse the linear response of the pressure-anisotropic gyrokinetic system, and show it to be a generalization of previously explored limits. The effects of pressure anisotropy on the stability and collisionless damping of Alfvénic and compressive fluctuations are highlighted, with attention paid to the spectral location and width of the frequency jump that occurs as Alfvén waves transition into kinetic Alfvén waves. Secondly, we derive and discuss a very general gyrokinetic free-energy conservation law, which captures both the KRMHD free-energy conservation at long wavelengths and dual cascades of kinetic Alfvén waves and ion entropy at sub-ion-Larmor scales. We show that non-Maxwellian features in the distribution function change the amount of phase mixing and the efficiency of magnetic stresses, and thus influence the partitioning of free energy amongst the cascade channels. Thirdly, a simple model is used to show that pressure anisotropy, even within the bounds imposed on it by firehose and mirror instabilities, can cause order-of-magnitude variations in the ion-to-electron heating ratio due to the dissipation of Alfvénic turbulence. Our theory provides a foundation for determining how pressure anisotropy affects turbulent fluctuation spectra, the differential heating of particle species and the ratio of parallel and perpendicular phase mixing in space and astrophysical plasmas.
Alison R. Yung, Professor of Psychiatry,
Kathryn M. Abel, Professor of Psychological Medicine and Director of the Centre for Women's Mental Health (CWMH) at the University of Manchester,
Sarah Cornick, works for the South London
Holly is an 18-year-old student who lives with her mother in an inner-city area. She had been well until about 5 months previously. In spite of being an above-average student, she started having difficulty with schoolwork. She became easily flustered about homework, frequently missed deadlines and cried about how stressed and tired she felt. She started missing school frequently.
Two months later, Holly started having aches and strange feelings all over and inside her body. She started hearing indistinct whispers, which distressed and further distracted her. The whispering gradually became clearer, until she could make out voices telling her she was ugly and really a man. She started to become unsure of her gender, attributing the strange bodily sensations to her changing sex. She later refused to attend school at all and also refused to see the general practitioner (GP).
Holly became increasingly tearful and stopped washing. She locked herself in her room and her GP advised her mother to take Holly to the local hospital for assessment. Holly was subsequently referred to the local community mental health team, which became concerned about her level of distress and the thoughts she was experiencing that life was not worth living. The mental health team identified her as having a psychotic illness and she was admitted to hospital.
Holly had no past history of psychiatric illness and her childhood was uneventful, except that her mother had experienced postnatal depression after Holly's birth. Holly's parents were divorced, but had shared custody. Although Holly had not visited her father for 3 months before admission, she felt she had a loving relationship with both of them. Her personality had been described as ‘bubbly and warm’ until 6 months before admission, when she had become less happy and more anxious than usual.
Holly was an in-patient for 3 weeks. She was treated with antipsychotic medication. She also received a sleeping tablet at night for a short period after her admission and underwent tests to make sure there were no underlying physical reasons for her symptoms.
Holly settled quickly on the ward and had a good rapport with her treatment team (psychiatrists, nurses, psychologist and occupational therapist).
Dynamics of marine-terminating major outlet glaciers are of high interest because of their potential for drawing down large areas of the Greenland ice sheet. We quantify short-term changes in ice flow speed and calving at a major West Greenland glacier and examine their relationship to the presence of the sea-ice melange and tidal stage. A field campaign at the terminus of Store Gletscher (70.40˚N, 50.55˚W) spanning the spring and summer of 2008 included four broadband seismometers, three time-lapse cameras, a tide gauge, an automatic weather station and an on-ice continuous GPS station. Sub-daily fluctuations in speed coincide with two modes of oceanic forcing: (1) the removal of the ice melange from the terminus front and (2) tidal fluctuations contributing to speed increases following ice melange removal. Tidal fluctuations in ice flow speed were observed 16km from the terminus and possibly extend further. Seismic records suggest that periods of intensive calving activity coincide with ice-flow acceleration following breakup of the melange in spring. A synchronous increase in speed at the front and clearing of the melange suggests that the melange directly resists ice flow. We estimate a buttressing stress (~30–60 kPa) due to the presence of the ice melange that is greater than expected from the range of observed tides, though an order of magnitude less than the driving stress.
Phenylketonuria (PKU), a genetic metabolic disorder that is characterized by the inability to convert phenylalanine to tyrosine, leads to severe intellectual disability and other cerebral complications if left untreated. Dietary treatment, initiated soon after birth, prevents most brain-related complications. A leading hypothesis postulates that a shortage of brain monoamines may be associated with neurocognitive deficits that are observable even in early-treated PKU. However, there is a paucity of evidence as yet for this hypothesis.
We therefore assessed in vivo striatal dopamine D2/3 receptor (D2/3R) availability and plasma monoamine metabolite levels together with measures of impulsivity and executive functioning in 18 adults with PKU and average intellect (31.2 ± 7.4 years, nine females), most of whom were early and continuously treated. Comparison data from 12 healthy controls that did not differ in gender and age were available.
Mean D2/3R availability was significantly higher (13%; p = 0.032) in the PKU group (n = 15) than in the controls, which may reflect reduced synaptic brain dopamine levels in PKU. The PKU group had lower plasma levels of homovanillic acid (p < 0.001) and 3-methoxy-4-hydroxy-phenylglycol (p < 0.0001), the predominant metabolites of dopamine and norepinephrine, respectively. Self-reported impulsivity levels were significantly higher in the PKU group compared with healthy controls (p = 0.033). Within the PKU group, D2/3R availability showed a positive correlation with both impulsivity (r = 0.72, p = 0.003) and the error rate during a cognitive flexibility task (r = 0.59, p = 0.020).
These findings provide further support for the hypothesis that executive functioning deficits in treated adult PKU may be associated with cerebral dopamine deficiency.
The study aims to assess whether supplementation with the probiotic Lactobacillus rhamnosus HN001 (HN001) can reduce the prevalence of gestational diabetes mellitus (GDM). A double-blind, randomised, placebo-controlled parallel trial was conducted in New Zealand (NZ) (Wellington and Auckland). Pregnant women with a personal or partner history of atopic disease were randomised at 14–16 weeks’ gestation to receive HN001 (6×109 colony-forming units) (n 212) or placebo (n 211) daily. GDM at 24–30 weeks was assessed using the definition of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) (fasting plasma glucose ≥5·1 mmol/l, or 1 h post 75 g glucose level at ≥10 mmol/l or at 2 h ≥8·5 mmol/l) and NZ definition (fasting plasma glucose ≥5·5 mmol/l or 2 h post 75 g glucose at ≥9 mmol/l). All analyses were intention-to-treat. A total of 184 (87 %) women took HN001 and 189 (90 %) women took placebo. There was a trend towards lower relative rates (RR) of GDM (IADPSG definition) in the HN001 group, 0·59 (95 % CI 0·32, 1·08) (P=0·08). HN001 was associated with lower rates of GDM in women aged ≥35 years (RR 0·31; 95 % CI 0·12, 0·81, P=0·009) and women with a history of GDM (RR 0·00; 95 % CI 0·00, 0·66, P=0·004). These rates did not differ significantly from those of women without these characteristics. Using the NZ definition, GDM prevalence was significantly lower in the HN001 group, 2·1 % (95 % CI 0·6, 5·2), v. 6·5 % (95 % CI 3·5, 10·9) in the placebo group (P=0·03). HN001 supplementation from 14 to 16 weeks’ gestation may reduce GDM prevalence, particularly among older women and those with previous GDM.
Africa and the ICC: Perceptions of Justice comprises contributions from prominent scholars of different disciplines including international law, political science, cultural anthropology, African history and media studies. This unique collection provides the reader with detailed insights into the interaction between the African Union and the International Criminal Court (ICC), but also looks further at the impact of the ICC at a societal level in African states and examines other justice mechanisms on a local and regional level in these countries. This investigation of the ICC's complicated relationship with Africa allows the reader to see that perceptions of justice are multilayered.