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Children with autism spectrum disorder (ASD) have increased susceptibility to anxiety disorders. Variation in a common ASD symptom, insistence on sameness behaviour, may predict future anxiety symptoms.
To describe the joint heterogeneous longitudinal trajectories of insistence on sameness and anxiety in children with ASD and to characterise subgroups at higher risk for anxiety.
In a longitudinal ASD cohort (n = 421), insistence on sameness behaviour was measured using the Autism Diagnostic Interview-Revised at approximately ages 3, 6 and 11 years. Anxiety was quantified at 8 time points between ages 3 and 11 years using the Child Behavior Checklist (CBCL) (parent report). Clusters of participants following similar trajectories were identified using group-based and joint trajectory modelling.
Three insistence on sameness trajectories were identified: (a) ‘low-stable’ (41.7% of participants), (b) ‘moderate-increasing’ (52.0%) and (c) ‘high-peaking’ (i.e. increasing then stabilising/decreasing behaviour) (6.3%). Four anxiety trajectories were identified: (a) ‘low-increasing’ (51.0%), (b) ‘moderate-decreasing’ (16.2%), (c) ‘moderate-increasing’ (19.6%) and (d) ‘high-stable’ (13.1%). Of those assigned to the ‘high-peaking’ insistence on sameness trajectory, 95% jointly followed an anxiety trajectory that surpassed the threshold for clinical concern (T-score >65) by middle childhood (anxiety trajectories 3 or 4). Insistence on sameness and anxiety trajectories were similar in severity and direction for 64% of the sample; for 36%, incongruous patterns were seen (e.g. decreasing anxiety and increasing insistence on sameness).
The concurrent assessment of insistence on sameness behaviour and anxiety in ASD may help in understanding current symptom profiles and anticipating future trajectories. High preschool insistence on sameness in particular may be associated with elevated current or future anxiety symptoms.
The level of anxiety depending on existing bruxist behaviour between temporomandibular joint disorder (TMJD) patients and asymptomatic volunteers was compared.
TMJD in 40 patients (mean age 35.5, 76% women) was diagnosed using RDC/TMD Axis I and was confirmed by magnetic resonance imaging. The control group consisted of 25 asymptomatic volunteers (mean age 23.4, 72% women). Bruxism was diagnosed based on case history and clinical findings. The anxiety was confirmed by State-Trait Anxiety Inventory (STAI).
A higher level of anxiety was determined for all examined patients (the mean score in STAI 1=38.43, STAI 2=46.10). There was no statistically significant difference (p>0.05) with respect to the control group (STAI 1=34.25, STAI 2=39.00). Including only patients with determined anxiety depending on age and gender resulted in 62.5% of patients with anxiety according to the STAI 1=42.84, and 72.5% of patients with anxiety according to the STAI 2=44.20. Only 16% subjects from the control group and 40% patients had bruxism. There was a statistically significant difference in scores of both STAI tests in patients with bruxist behaviour (p<0.001). Statistically significant differences between patients with lower (1-4) and higher (5-10) degree of pain were rated on a visual-analogue scale for State-Trait Anxiety Inventory 2 (p=0.012).
This study has confirmed the connection between anxiety and bruxism as one of the central etiological factors. However, patients with TMJD experience a higher level of anxiety. Patients with estimated VAS pain score ≥5 show significantly more anxiety on STAI 2 subscale.
Level of anxiety and pain intensity before and after splint treatment of patients with temporomandibular joint disorder (TMJD) was compared.
TMJD in 60 patients (mean age 37.9 years, 80% women) was diagnosed using patient's history and clinical examination, and was confirmed by magnetic resonance imaging of the TMJs. Pain intensity was rated on a visual-analogue scale. The anxiety was confirmed by Spielberger's State-Trait Anxiety Inventory (STAI).
A higher level of anxiety was determined due to the fact that the mean score in STAI 1 was 39.80 and STAI 2 was 41.10. Before visiting a dentist, the patients suffered pain for 8.7 months on average. There is a statistically significant difference between patients depending on how long they previously suffered pain and anxiety values for all patients in STAI 1 and 2 (p< 0.0001). Including only patients with determined anxiety depending on age and gender there was no statistical difference in previous pain duration (p>0.05). There is a correlation between anxiety values on STAI 1 scale and post-treatment pain intensity (p< 0.026), and on STAI 2 scale pain intensity proved to be statistically significant before (p< 0.002) and after (p< 0.049) treatment. There was a statistically significant difference in scores of STAI 2 tests of patients with bruxism behaviour (p< 0.042).
There is a possibility of negative interaction of psychological and psychosocial factors within all forms of musculoskeletal disorders’ treatment, including TMDs. This study confirmed the connection between anxiety and various categories of pain intensity in patients during splint treatment.
Today, the most powerful research technique available for assigning chronometric age to human cultural objects is radiocarbon dating. Developed in the United States in the late 1940s by an alumnus of the Manhattan Project, radiocarbon dating measures the decay of the radioactive isotope carbon-14 (C14) in organic material, and calculates the time elapsed since the materials were removed from the life cycle. This paper traces the interdisciplinary collaboration between archaeology and radiochemistry that led to the successful development of radiocarbon dating in the early 1950s, following the movement of people and ideas from Willard Libby's Chicago radiocarbon laboratory to museums, universities and government labs in the United States, Australia, Denmark and New Zealand. I show how radiocarbon research built on existing technologies and networks in atomic chemistry and physics but was deeply shaped by its original private philanthropic funders and archaeologist users, and ultimately remained to the side of many contemporaneous Cold War scientific and military projects.
The first aim of this study was to provide prevalence suicidal feelings over time (past week, past month, past year and lifetime) in a population-based sample of old to very old adults without dementia. Does prevalence change with rising age? The second aim was to examine the fluctuation of suicidal feelings over time. How does this coincide with depression status?
Data were derived from the Gothenburg H70 Birth Cohort Studies (the H70 studies) which are multidisciplinary longitudinal studies on ageing. A representative sample of adults in Gothenburg, Sweden with birth years 1901–1944 were invited to take part in a longitudinal health study on ageing and participated at one or more occasions during 1986–2014. The sample consisted of 6668 observations originating from 3972 participants without dementia between the ages of 70 and 108, including 1604 participants with multiple examination times. Suicidal feelings were examined during a psychiatric interview using the Paykel questions (life not worth living, death wishes, thoughts of taking own life, seriously considered taking life, attempted suicide).
Prevalence figures for suicidal feelings of any severity were as follows: past week 4.8%, past month 6.7%, past year 11.2% and lifetime 25.2%. Prevalence rates increased with age in the total group and in women but not in men. Suicidal feelings were common in participants with concurrent major or minor depression, but over a third of the participants who reported suicidal feelings did not fulfil criteria for these diagnoses nor did they present elevated mean depressive symptom scores. The majority of participants consistently reported no experience of suicidal feelings over multiple examination times, but fluctuation was more common in women compared with men.
Suicidal feelings in late-life are uncommon in individuals without depression indicating that such behaviour is not a widespread, normative phenomenon. However, such feelings may occur outside the context of depression.
All canine hookworms are known to be zoonotic, causing infections ranging from transient skin irritations to prolonged ‘creeping eruptions’, eosinophilic enteritis and even patent intestinal infections. There is little information on canine hookworm species and their public health significance in sub-Saharan Africa. This study determined the prevalence and species of hookworms in dogs from different climatic zones of Kenya. Dog faecal samples were collected from the environment, and hookworm eggs were isolated by zinc chloride flotation and subjected to DNA extraction. Polymerase chain reaction (PCR) assays targeting the internal transcribed spacer (ITS) 1 and 2, 5.8S and 28S ribosomal RNA of Ancylostoma spp. and Uncinaria stenocephala were performed, and hookworm species were identified by PCR-restriction fragment length polymorphism (RFLP) or DNA sequencing. Hookworm eggs were detected by microscopy in 490/1621 (30.23%, 95% CI 28.01–32.54) faecal samples. Estimates of faecal prevalence were high in counties receiving higher rainfall (Narok 46.80%, Meru 44.88%) and low in those with a more arid climate (Isiolo 19.73%, Turkana 11.83%). In a subset of 70 faecal samples, Ancylostoma caninum (n = 59) was the most common species, followed by A. braziliense (n = 10) and A. cf. duodenale (n = 1). This study reports for the first time the detection of A. cf. duodenale in dog faeces and zoonotic hookworm species in Kenyan dogs. These findings emphasize the need for control measures such as enforcing laws for restraining stray dogs, regular deworming of dogs, and public health awareness programmes aimed at informing communities on outdoor use of footwear.
With more long-acting injectable (LAI) antipsychotics available for treating schizophrenia, each with variable durations of action (2 weeks to 3 months), it is important to have clear management strategies for patients developing breakthrough psychotic symptoms or experiencing symptomatic worsening on LAIs. However, no treatment guidelines or clinical practice pathways exist; health-care providers must rely on their own clinical judgment to manage these patients. This article provides practical recommendations—based on a framework of clinical, pharmacokinetic, and dosing considerations—to guide clinicians’ decisions regarding management of breakthrough psychotic symptoms. Management options include ruling out/addressing medical illness or substance abuse/misuse as a contributing factor, addressing stressors, optimizing nonpharmacologic treatments, treating medical/psychiatric comorbidities, ensuring proper LAI administration technique, addressing missed LAI doses or lack of steady-state attainment, and increasing LAI dose directly or indirectly by shortening the injection interval (off-label). If these strategies do not work sufficiently with frequent monitoring, the LAI could be supplemented with a low dose of the corresponding oral formulation for fast symptom control (off-label). However, caution should be exercised with this strategy, because data on the safety of concomitant use of LAI and oral antipsychotics (OAPs) are limited, especially over extended periods. If symptoms abate, therapy optimization could be continued and slow discontinuation of the OAP could be considered. For persistent/worsening symptoms, the OAP should be increased to optimum effective dose while intensifying the initial steps used before it was added. If this fails, switching the OAP or LAI could be considered. We believe that these strategies will help clinicians manage breakthrough psychotic symptoms during LAI treatment and improve overall outcomes among those who can benefit from LAIs.
Measurements of the radiocarbon (14C) and tritium (3H) activity in a 5.8-m-long ice core from the Saarhalle, Dachstein-Mammoth Cave allowed a substantial revision of previous opinions concerning the age of the ice block, and provide useful experience that may be applied to future 14C dating of cave ice deposits. The stepped combustion technique results in a remarkably older radiocarbon age for the 800°C than for the 400°C fractions of the carbonaceous matter from ice layer samples. The highest tritium activity (37.2±1.2 TU) can be linked to the period of anthropogenically increased tritium activity of atmospheric precipitation at the mid-1960s, providing a well-dated radiochemical reference horizon. Compared the 3H-based extrapolated ages of two shallow samples to the expected atmospheric signal an average 14C reservoir bias of ~1500 BP was obtained for the insoluble organic fraction combusted at 400°C. The conventional 14C age measured for the 400°C fraction of the deeper samples has been corrected with the average reservoir bias. The median calibrated age of the deepest analyzed sample of the ice profile is ~1830 cal BC and a linear extrapolation to the bottom ice layer gave 2590 cal BC, making the Saarhalle ice block among the oldest dated cave ice deposits known in the Alpine domain.
Measures of social cognition are increasingly being applied to psychopathology, including studies of schizophrenia and other psychotic disorders. Tests of social cognition present unique challenges for international adaptations. The Mayer–Salovey–Caruso Emotional Intelligence Test, Managing Emotions Branch (MSCEIT-ME) is a commonly-used social cognition test that involves the evaluation of social scenarios presented in vignettes.
This paper presents evaluations of translations of this test in six different languages based on representative samples from the relevant countries. The goal was to identify items from the MSCEIT-ME that show different response patterns across countries using indices of discrepancy and content validity criteria. An international version of the MSCEIT-ME scoring was developed that excludes items that showed undesirable properties across countries.
We then confirmed that this new version had better performance (i.e. less discrepancy across regions) in international samples than the version based on the original norms. Additionally, it provides scores that are comparable to ratings based on local norms.
This paper shows that it is possible to adapt complex social cognitive tasks so they can provide valid data across different cultural contexts.
The zoonotic cestode Echinococcus ortleppi (Lopez-Neyra and Soler Planas, 1943) is mainly transmitted between dogs and cattle. It occurs worldwide but is only found sporadically in most regions, with the notable exception of parts of southern Africa and South America. Its epidemiology is little understood and the extent of intraspecific variability is unknown. We have analysed in the present study the genetic diversity among 178 E. ortleppi isolates from sub-Saharan Africa, Europe and South America using the complete mitochondrial cox1 (1608 bp) and nad1 (894 bp) DNA sequences. Genetic polymorphism within the loci revealed 15 cox1 and six nad1 haplotypes, respectively, and 20 haplotypes of the concatenated genes. Presence of most haplotypes was correlated to geographical regions, and only one haplotype had a wider spread in both eastern and southern Africa. Intraspecific microvariance was low in comparison with Echinococcus granulosus sensu stricto, despite the wide geographic range of examined isolates. In addition, the various sub-populations showed only subtle deviation from neutrality and were mostly genetically differentiated. This is the first insight into the population genetics of the enigmatic cattle adapted Echinococcus ortleppi. It, therefore, provides baseline data for biogeographical comparison among E. ortleppi endemic regions and for tracing its translocation paths.
Soda consumption is high in the USA, especially among minorities and individuals of lower socio-economic status (SES); this may be due to its affordable price in relation to healthier alternatives. The objective of the present study was to examine geospatial variation in price of milk and soda, and the price of milk relative to soda, by neighbourhood SES and proportion of Hispanic and black individuals.
Retailer soda and milk prices (n 2987; Information Resources, Inc. Academic Data Set 2004–2011) were linked to census block group sociodemographic characteristics (American Community Survey 2005–2009). Linear hierarchical regression models were used to adjust for confounders.
Large chain supermarkets and superstores (n 1743) in forty-one states and 1694 block groups (USA).
For equivalent fluid ounces, price of soda on average was 62 % lower than milk ($US 0·23 v. $US 0·63 per serving) and there was high dispersion in milk price across geographic areas. After adjustment for confounding, neighbourhoods with a higher concentration of black and Hispanic individuals tended to have lower soda prices and higher milk prices (−$US 0·001 and +$US 0·007 in price per serving, respectively, for a one quintile increase in black/Hispanic population), while soda and milk both became less expensive as SES decreased (–$US 0·002 and −$US 0·015 in serving price per one sd decrease in SES index, respectively).
Neighbourhoods with a higher concentration of blacks and Hispanics may be at greater risk of higher soda consumption due to more affordable prices, in absolute terms and relative to the price of milk.
The number of separable cognitive dimensions in schizophrenia has been debated. Guided by the extant factor analytic literature, the NIMH Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative selected seven cognitive domains relevant to treatment studies in schizophrenia: speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning and problem solving, and social cognition. These domains are assessed in the MATRICS Consensus Cognitive Battery (MCCB). The aim of this study was to conduct a confirmatory factor analysis (CFA) of the beta battery of the MCCB to compare the fit of the MATRICS consensus seven-domain model to other models in the current literature on cognition in schizophrenia.
Using data from 281 schizophrenia outpatients, we compared the seven correlated factors model with alternative models. Specifically, we compared the 7-factor model to (a) a single-factor model, (b) a three correlated factors model including speed of processing, working memory, and general cognition, and (c) a hierarchical model in which seven first-order factors loaded onto a second-order general cognitive factor.
Multiple fit indices indicated the seven correlated factors model was the best fit for the data and provided significant improvement in model fit beyond the comparison models.
These results support the assessment of these seven cognitive dimensions in clinical trials of interventions to improve cognition in schizophrenia. Because these cognitive factors are separable to some degree, it is plausible that specific interventions may have differential effects on the domains.