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On 15 March 2019, a white supremacist terrorist attacked two mosques in Christchurch, New Zealand. Fifty-one people were killed and another 40 sustained non-fatal gunshot injuries.
Aims
To examine the mental health of the Muslim community, and individual and exposure-related factors associated with mental health outcomes.
Method
This is the baseline analysis of a longitudinal study of adults from the Muslim community interviewed 11–32 months after the shootings. It included a diagnostic interview (MINI), measures of sociodemographic factors, prior mental health, prior traumatic events, exposure in the attacks, discrimination, life stressors, social support and religious coping. Logistic regression models examined associations with mental health outcomes.
Results
The sample comprised 189 participants (mean age 41 (s.d. = 13); 60% female), and included: bereaved, 17% (n = 32); injured survivors 12% (n = 22); non-injured survivors, 19% (n = 36); family members of survivors, 35% (n = 67); and community members without the above exposures, 39% (n = 74). Overall, 61% had at least one mental disorder since the attacks. Those bereaved (P < 0.01, odds ratio 4.28, 95% CI 1.75–10.49) and survivors, whether injured (P < 0.001, odds ratio 18.08, 95% CI 4.70–69.60) or not (P < 0.01, odds ratio 5.26, 95% CI 1.99–13.89), had greater odds of post-traumatic stress disorder. Those bereaved (P < 0.001, odds ratio 5.79, 95% CI 2.49–13.46) or injured (P = 0.04, odds ratio 4.43, 95% CI 1.07–18.28) had greater odds of depression.
Conclusions
Despite unique features of this attack on a Muslim population, findings accord with previous studies. They suggest generalisability of psychopathology after terror attacks, and that being bereaved or directly experiencing such events is associated with adverse mental health outcomes.
Trial registration number
The study is registered on the Australian NZ Clinical Trials Registry (ACTRN12620000909921).
Using data from a 15-year longitudinal follow-up of a randomized controlled trial of a parenting-focused preventive intervention for divorced families (N = 240) with children aged 9–12, the current study examined alternative cascading pathways through which the intervention led to improvements in offspring’s perceived health problems, BMI, and cigarette smoking in emerging adulthood. It was hypothesized that the program would lead to improvements in these health-related outcomes during emerging adulthood through progressive associations between program-induced changes in parenting and offspring outcomes, including mental health problems, substance use, and competencies. Intervention-induced improvements in positive parenting at posttest led to improvements in mental health problems in late childhood/early adolescence, which led to lower levels of mental health and substance use problems as well as higher levels of competencies in adolescence, which led to improvements in the health-related outcomes. Academic performance predicted all three health-related outcomes and other aspects of adolescent functioning showed different relations across outcomes. Results highlight the potential for intervention effects of preventive parenting interventions in childhood to cascade over time to affect health-related outcomes in emerging adulthood.
There are numerous challenges pertaining to epilepsy care across Ontario, including Epilepsy Monitoring Unit (EMU) bed pressures, surgical access and community supports. We sampled the current clinical, community and operational state of Ontario epilepsy centres and community epilepsy agencies post COVID-19 pandemic. A 44-item survey was distributed to all 11 district and regional adult and paediatric Ontario epilepsy centres. Qualitative responses were collected from community epilepsy agencies. Results revealed ongoing gaps in epilepsy care across Ontario, with EMU bed pressures and labour shortages being limiting factors. A clinical network advising the Ontario Ministry of Health will improve access to epilepsy care.
Helium or neopentane can be used as surrogate gas fill for deuterium (D2) or deuterium-tritium (DT) in laser-plasma interaction studies. Surrogates are convenient to avoid flammability hazards or the integration of cryogenics in an experiment. To test the degree of equivalency between deuterium and helium, experiments were conducted in the Pecos target chamber at Sandia National Laboratories. Observables such as laser propagation and signatures of laser-plasma instabilities (LPI) were recorded for multiple laser and target configurations. It was found that some observables can differ significantly despite the apparent similarity of the gases with respect to molecular charge and weight. While a qualitative behaviour of the interaction may very well be studied by finding a suitable compromise of laser absorption, electron density, and LPI cross sections, a quantitative investigation of expected values for deuterium fills at high laser intensities is not likely to succeed with surrogate gases.
Ketamine is an effective short-term treatment for a range of psychiatric disorders. A key question is whether the addition of psychotherapy to ketamine treatment improves outcomes or delays relapse.
Aim
To identify all studies combining psychotherapy with ketamine for the treatment of psychiatric disorders to summarise their effects and make recommendations for future research.
Method
The review protocol was prospectively registered with PROSPERO (registration number CRD42022318120). Potential studies were searched for in MEDLINE, Embase, PsycINFO, SCOPUS, the Cochrane library and Google Scholar. Eligible studies combined ketamine and psychotherapy for the treatment of psychiatric disorders and did not use case reports or qualitative designs. Key findings relating to psychotherapy type, diagnosis, ketamine protocol, sequencing of psychotherapy and study design are reported. Risk of bias was assessed using modified Joanna Briggs critical appraisal tools.
Results
Nineteen studies evaluating 1006 patients were included in the systematic review. A variety of supportive individual and group, manualised and non-manualised psychotherapies were used. The majority of studies evaluated substance use disorders, post-traumatic stress disorder and treatment-resistant depression. Ketamine protocols and sequencing of ketamine/psychotherapy treatment varied substantially between studies. Outcomes were largely positive for the addition of psychotherapy to ketamine treatment.
Conclusion
The combination of psychotherapy and ketamine offers promise for the treatment of psychiatric disorders, but study heterogeneity prevents definitive recommendations for their integration. Larger randomised controlled trials using manualised psychotherapies and standardised ketamine protocols are recommended to clarify the extent to which the addition of psychotherapy to ketamine improves outcomes over ketamine treatment alone.
Despite three decades of research, gaps remain in meeting the needs of people with dementia and their family/friend carers as they navigate the often-tumultuous process of driving cessation. This paper describes the process of using a knowledge-to-action (KTA) approach to develop an educational web-based resource (i.e. toolkit), called the Driving and Dementia Roadmap (DDR), aimed at addressing some of these gaps.
Design:
Aligned with the KTA framework, knowledge creation and action cycle activities informed the development of the DDR. These activities included systematic reviews; meta-synthesis of qualitative studies; interviews and focus groups with key stakeholders; development of a Driving and Dementia Intervention Framework (DD-IF); and a review and curation of publicly available resources and tools. An Advisory Group comprised of people with dementia and family carers provided ongoing feedback on the DDR’s content and design.
Results:
The DDR is a multi-component online toolkit that contains separate portals for current and former drivers with dementia and their family/friend carers. Based on the DD-IF, various topics of driving cessation are presented to accommodate users’ diverse stages and needs in their experiences of decision-making and transitioning to non-driving.
Conclusion:
Guided by the KTA framework that involved a systematic and iterative process of knowledge creation and translation, the resulting person-centered, individualized and flexible DDR can bring much-needed support to help people with dementia and their families maintain their mobility, community access, and social and emotional wellbeing during and post-driving cessation.
Captive primates rarely have to spend as much time searching for, obtaining and processing food as do their wild counterparts. Enrichment techniques designed to encourage captive primates to spend more species-appropriate amounts of time in foraging behaviours have been successful. The present study measured the behavioural effects of four feeding enhancements: two devices (mats and puzzles) and two foods (produce and frozen juice), on four cohorts (n = 63) of single-caged, yearling rhesus macaques (Macaca mulatta). Devices required considerable manipulation to retrieve rewards, whereas enrichment foods required additional processing. Analyses compared periods when one of the enhancements was available to interim periods when no enhancements were available. Planned comparisons revealed that subjects spent more time feeding, and less time inactive, self-grooming, exploring and behaving socially when feeding enrichment was available. Significantly more time was spent feeding when enrichment foods were provided, but more time was spent playing and using enrichment when devices were in the cage. More time was spent self-grooming and exploring with the acrylic puzzle than with the artificial turf mat. Subjects spent significantly more time feeding when produce was available than when frozen juice was available. Feeding enhancements resulted in more species-typical patterns of activity for single-caged, yearling rhesus. Since feeding devices were used in species-typical activities in addition to feeding, devices may be more valuable than foods. Feeding enrichment programmes which combine stimulating devices with foods that are novel and require processing can positively affect the behaviour of captive primates.
Enrichment of the environments of captive primates is currently of interest as both a basic and an applied research question, particularly when social and inanimate enhancements are used simultaneously. We measured the behavioural effects of two intensities of inanimate enrichment on 12 unimale-multifemale groups and 12 all-male groups from three cohorts of three to four-year-old rhesus macaques (Macaca mulatta). Half of the groups received a simple, inexpensive enrichment programme while the other groups received a more complex and costly combination of physical andfeeding enhancements. Observations were conducted on 93 subadults of both sexes during their initial year of group housing. Intensity of enrichment did not differentially affect the amount of time subjects spent in any of the activities analysed. Subjects that received the more complex programme spent only 8.3 per cent of their time using the extra enhancements. Therefore, there was little demonstrated benefit of the more costly enrichment programme. The three cohorts differed in the amount of time that they spent inactive, behaving agonistically, playing and located near a group mate. A planned comparison of one cohort that had been single-housed without visual access to social groups, to the two cohorts that had visual access to social groups during single caging, revealed differences in play and socially-located behaviour, which may have been due to differences in extra-cage conditions two years prior to the present study. When primates are housed socially with conspecifics as ‘social enhancements ‘, the relatively simple inanimate enrichment programme we used was as effective as the more costly programme. When enrichment resources are limited, inanimate enrichment efforts should be focused on monkeys that are not socially enriched.
The COVID-19 pandemic exacerbated gender disparities in some academic disciplines. This study examined the association of the pandemic with gender authorship disparities in clinical neuropsychology (CN) journals.
Method:
Author bylines of 1,018 initial manuscript submissions to four major CN journals from March 15 through September 15 of both 2019 and 2020 were coded for binary gender. Additionally, authorship of 40 articles published on pandemic-related topics (COVID-19, teleneuropsychology) across nine CN journals were coded for binary gender.
Results:
Initial submissions to these four CN journals increased during the pandemic (+27.2%), with comparable increases in total number of authors coded as either women (+23.0%) or men (+25.4%). Neither the average percentage of women on manuscript bylines nor the proportion of women who were lead and/or corresponding authors differed significantly across time. Moreover, the representation of women as authors of pandemic-related articles did not differ from expected frequencies in the field.
Conclusions:
Findings suggest that representation of women as authors of peer-reviewed manuscript submissions to some CN journals did not change during the initial months of the COVID-19 pandemic. Future studies might examine how risk and protective factors may have influenced individual differences in scientific productivity during the pandemic.
Neuroimaging offers great potential to clinicians and researchers for a host of mental and physical conditions. The use of imaging has been trumpeted for forensic psychiatric and psychological evaluations to allow greater insight into the relationship between the brain and behavior. The results of imaging certainly can be used to inform clinical diagnoses; however, there continue to be limitations in using neuroimaging for insanity cases due to limited scientific backing for how neuroimaging can inform retrospective evaluations of mental state. In making this case, this paper reviews the history of the insanity defense and explains how the use of neuroimaging is not an effective way of improving the reliability of insanity defense evaluations.
The objective of the current study was to identify factors across the socio-ecological model (SEM) associated with adolescents’ sugar-sweetened beverage (SSB) intake.
Design:
This cross-sectional study surveyed adolescents using previously validated instruments. Analyses included descriptive statistics, ANOVA tests and stepwise nonlinear regression models (i.e., two-part models) adjusted to be cluster robust. Guided by SEM, a four-step model was used to identify factors associated with adolescent SSB intake – step 1: demographics (i.e., age, gender), step 2: intrapersonal (i.e., theory of planned behaviour (attitudes, subjective norms, perceived behavioural control, behavioural intentions), health literacy, media literacy, public health literacy), step 3: interpersonal (i.e., caregiver’s SSB behaviours, caregiver’s SSB rules) and step 4: environmental (i.e., home SSB availability) level variables.
Setting:
Eight middle schools across four rural southwest Virginia counties in Appalachia.
Participants:
Seven hundred ninety seventh grade students (55·4 % female, 44·6 % males, mean age 12 (sd 0·5) years).
Results:
Mean SSB intake was 36·3 (sd 42·5) fluid ounces or 433·4 (sd 493·6) calories per day. In the final step of the regression model, seven variables significantly explained adolescent’s SSB consumption: behavioural intention (P < 0·05), affective attitude (P < 0·05), perceived behavioural control (P < 0·05), health literacy (P < 0·001), caregiver behaviours (P < 0·05), caregiver rules (P < 0·05) and home availability (P < 0·001).
Conclusions:
SSB intake among adolescents in rural Appalachia was nearly three times above national mean. Home environment was the strongest predictor of adolescent SSB intake, followed by caregiver rules, caregiver behaviours and health literacy. Future interventions targeting these factors may provide the greatest opportunity to improve adolescent SSB intake.
Cognitive impairment plays a key role in determining the course of illness and functional outcomes in mood disorders. This article summarises and discusses important papers within this thematic series of BJPsych Open that contribute to a greater understanding of the complexity of ‘Cognition in Mood Disorders’.
Emotional cognition and effective interpretation of affective information is an important factor in social interactions and everyday functioning, and difficulties in these areas may contribute to aetiology and maintenance of mental health conditions. In younger people with depression and anxiety, research suggests significant alterations in behavioural and brain activation aspects of emotion processing, with a tendency to appraise neutral stimuli as negative and attend preferentially to negative stimuli. However, in ageing, research suggests that emotion processing becomes subject to a ‘positivity effect’, whereby older people attend more to positive than negative stimuli.
Aims
This review examines data from studies of emotion processing in Late-Life Depression and Late-Life Anxiety to attempt to understand the significance of emotion processing variations in these conditions, and their interaction with changes in emotion processing that occur with ageing.
Method
We conducted a systematic review following PRISMA guidelines. Articles that used an emotion-based processing task, examined older persons with depression or an anxiety disorder and included a healthy control group were included.
Results
In Late-Life Depression, there is little consistent behavioural evidence of impaired emotion processing, but there is evidence of altered brain circuitry during these processes. In Late-Life Anxiety and Post-Traumatic Stress disorder, there is evidence of interference with processing of negative or threat-related words.
Conclusions
How these findings fit with the positivity bias of ageing is not clear. Future research is required in larger groups, further examining the interaction between illness and age and the significance of age at disease onset.
Cognitive impairment is a core feature of depression and has a negative effect on a person's functioning, in psychosocial and interpersonal areas, and on workforce performance. Cognitive impairment often persists, even with the remittance of mood symptoms. One potential way of improving treatment of cognitive impairment would be to identify variables that predict cognitive change in patients with depression.
Aims
To systematically examine findings from studies that investigate baseline variables and how they predict, or correlate with, cognitive change in mood disorders, and to examine methodological issues from these studies.
Method
Studies that directly measured associations between at least one baseline variable and change in cognitive outcome in patients with current major depressive episode were identified using PubMed and Web of Science databases. Narrative review technique was used because of the heterogeneity of patient samples, outcome measures and study procedures. The review was registered on PROSPERO with registration number CRD42020150975.
Results
Twenty-four studies met the inclusion criteria. Evidence from the present review for prediction of cognitive change from baseline variables was limited for demographic factors, with some preliminary evidence for depression, cognitive and biological factors. Identification of patterns across studies was difficult because of methodological variability across studies.
Conclusions
Findings from the present review suggest there may be some baseline variables that are useful in predicting cognitive change in mood disorders. This is an area warranting further research focus.
Cognitive impairment is considered a core feature of major depressive disorder (MDD) and research into psychological treatments aiming to address cognitive impairment are gaining momentum. Compared with the well-established research base of cognitive treatment trials in schizophrenia, including meta-analyses, mood disorder research is much more preliminary.
Aims
To focus on identifying the important factors to consider in developing larger-scale psychological treatment trials targeting cognitive impairment in mood disorders. Trial design recommendations have been published for cognitive treatment trials in bipolar disorder.
Method
An in-depth discussion of methodological considerations in the development of cognitive treatment trials for MDD.
Results
Methodological considerations include: screening for, and defining, cognitive impairment; mood state when cognitive intervention begins; medication monitoring during cognitive interventions; use of concomitant therapy; level of therapist involvement; duration and dose of treatment; choice of specific cognitive training exercises; home practice; improving adherence; appropriate comparison therapies in clinical trials; and choice of primary outcomes.
Conclusions
As well as guidance for clinical trial development, this review may be helpful for clinicians wanting to provide cognitive interventions for individuals with MDD.
To describe relationships among baseline characteristics, engagement indicators and outcomes for rural participants enrolled in SIPsmartER, a behavioural intervention targeting sugar-sweetened beverage (SSB) intake.
Design:
A secondary data analysis. Bivariate analyses determined relationships among baseline characteristics (e.g. age, gender, race, education, income), engagement indicators (completion of 6-month health screening, class attendance, call completion) and SSB outcomes (SSB ounce reduction (i.e. US fluid ounces; 1 US fl. oz = 29·57 ml), reduced ≥12 ounces, achieved ≤8 ounce intake). Generalized linear models tested for significant effects of baseline characteristics on engagement indicators and of baseline characteristics and engagement indicators on SSB outcomes.
Setting:
South-west Virginia, USA, a rural, medically underserved region.
Participants:
Participants’ (n 155) mean age was 41 years; most were female (81 %), White (91 %) and earned ≤$US 20 000 per annum (61 %).
Results:
All final models were significant. Engagement models predicted 12–17 % of variance, with age being a significant predictor in all three models. SSB outcome models explained 5–70 % of variance. Number of classes attended was a significant predictor of SSB ounce reduction (β = −6·12, P < 0·01). Baseline SSB intake significantly predicted SSB ounce reduction (β = −0·90, P < 0·001) and achieved ≤8 ounce intake (β = 0·98, P < 0·05).
Conclusions:
The study identifies several participant baseline characteristics that may impact engagement in and outcomes from a community-based intervention targeting SSB intake. Findings suggest greater attendance of SIPsmartER classes is associated with greater reduction in overall SSB intake; yet engagement variables did not predict other outcomes. Findings will inform the future implementation of SIPsmartER and research studies of similar design and intent.
The purpose of this study was to examine whether vehicle type based on size (car vs. other = truck/van/SUV) had an impact on the speeding, acceleration, and braking patterns of older male and female drivers (70 years and older) from a Canadian longitudinal study. The primary hypothesis was that older adults driving larger vehicles (e.g., trucks, SUVs, or vans) would be more likely to speed than those driving cars. Participants (n = 493) had a device installed in their vehicles that recorded their everyday driving. The findings suggest that the type of vehicle driven had little or no impact on per cent of time speeding or on the braking and accelerating patterns of older drivers. Given that the propensity for exceeding the speed limit was high among these older drivers, regardless of vehicle type, future research should examine what effect this behaviour has on older-driver road safety.