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Soil acidity and poor nutrient use efficiency are major limiting factors as regards output potential on heavy soils, soils which are dominated by high proportions of clay and organic matter, with impeded drainage, high buffering capacity and located in high rainfall areas. Lime is applied in order to counteract these limiting factors and in turn improve agricultural output and productivity. The current study investigates the effects of two commonly used lime products at three comparable treatment rates, ground lime (7.5, 5 and 2.5 tonne/ha) and granulated lime (7.5, 2.5 and 1.5 tonne/ha), applied across three distinct sites. The ability of each lime product and treatment rate to counteract soil acidity, increase nutrient availability and influence soil physical structure was assessed over time. On average across sites, 1 tonne/ha of each lime product increased soil pH by 0.15 and 0.21 pH units between ground and granulated lime, respectively. Site 3 experienced the greatest increase change in soil pH in comparison to the other two sites, largely due to lower clay content and cation exchange capacity. Granulated lime was 5.7 times more expensive than ground lime in its ability to reduce soil acidity. The high treatment rate showed the greatest reduction in soil acidity, aluminium and iron concentration as a mean across all sites. Morgan's soil test phosphorus concentration increased across all sites, with treatment rates having no effect on the rate of increase. There was evidence of reduced soil compaction and lime application showed no negative implication on soil physical structure.
The novel coronavirus 2019 (COVID-19) has spread worldwide threatening human health. To reduce transmission, a ‘lockdown’ was introduced in Ireland between March-May 2020. The aim of this study is to capture the experiences of Consultant Psychiatrists during lockdown and their perception of it’s impact on Mental Health Services.
A questionnaire designed by the Royal College of Psychiatrists was adapted and circulated to Consultant members of the College of Psychiatrists following the easing of restrictions. The questionnaire assessed the perceived impact on referral rates, mental health act provision, availability of Information Technology (IT), consultant well-being and availability of Personal Protective Equipment (PPE). Thematic analysis was employed to analyse free-text sections.
Response rate was 32% (N=197/623). Consultants reported an initial decrease/significant decrease in referrals in the first month of lockdown (68%, N=95/140) followed by an increase/significant increase in the second month for both new (83%, N=100/137) and previously attending patients (65%, N=88/136). Social isolation and reduced face-to-face mental health supports were among the main reasons identified. The needs of children and older adults were highlighted. Most consultants (76%, N=98/129) felt their working day was affected and their well-being reduced (52%, N=61/119). The majority felt IT equipment availability was inadequate (67%, N=88/132). Main themes identified from free-text sections were service management, relationship between patients and healthcare service and effects on consultants’ lives.
The COVID19 pandemic has placed increased pressure on service provision and consultant wellness. This further supports the longstanding need to increase mental health service investment in Ireland.
An open-label extension study (NCT02873208) evaluated the long-term tolerability, safety, and efficacy of combination olanzapine/samidorphan (OLZ/SAM) treatment in patients with schizophrenia. This qualitative sub study explored perceptions of benefit, burden, and satisfaction with previous medications and OLZ/SAM.
Semi-structured interviews (60 minutes; audio-recorded) were conducted. Interviewer sensitivity training, senior interviewer oversight, and a list of common medications to aid recall supported data collection. Interview transcripts were content coded and analyzed (NVivo v11.0).
All 41 patients reported a lifetime burden with schizophrenia adversely impacting employment, relationships, emotional health, social activities, and daily tasks. Hospitalization for schizophrenia management was another reported aspect of disease burden. Although most (n=32) patients reported previous medication benefits, side effects affecting physical, emotional/behavioral, and cognitive functioning were reported by all (n=41). Following OLZ/SAM treatment, 39/41 patients (95%) reported improvements in symptoms including hallucinations, paranoia, depression, sleep, and concentration. Furthermore, patients described improvements in self-esteem, social activities, relationships, and daily activities. Twenty-three patients (56%) reported side effects attributed to OLZ/SAM; lack of energy (n=12 [29%]) and dry mouth (n= 5 [12%]) were most common. Twenty-four (59%) patients were “very satisfied” with OLZ/SAM; most (n=35 [85%]) preferred to continue OLZ/SAM vs switching to another medication. As most substudy patients (n=40; 98%) completed the extension study, satisfied patients may be overrepresented in this analysis.
This qualitative interview approach provided valuable insight into patients’ experiences with previous medications and OLZ/SAM. Overall, most patients reported treatment satisfaction and improvements in symptoms, function, and health-related quality of life with OLZ/SAM.
To develop and test–retest the reproducibility of an ethnic-specific FFQ to estimate nutrient intakes for South Asians (SA) in New Zealand (NZ).
Using culturally appropriate methods, the NZFFQ, a validated dietary assessment tool for NZ adults, was modified to include SA food items by analysing foods consumed by SA participants of the Adult Nutrition Survey, in-person audit of ethnic food stores and a web scan of ethnic food store websites in NZ. This was further refined via three focus group discussions, and the resulting New Zealand South Asian Food Frequency Questionnaire (NZSAFFQ) was tested for reproducibility.
Auckland and Dunedin, NZ.
Twenty-nine and 110 males and females aged 25–59 years of SA ethnicity participated in the focus group discussions and the test–retest, respectively.
The development phase resulted in a SA-specific FFQ comprising of 11 food groups and 180 food items. Test–retest of the NZSAFFQ showed good reproducibility between the two FFQ administrations, 6 months apart. Most reproducibility coefficients were within or higher than the acceptable range of 0·5–0·7. The lowest intraclass correlation coefficients (ICC) were observed for β-carotene (0·47), vitamin B12 (0·50), fructose (0·55), vitamin C (0·57) and selenium (0·58), and the highest ICC were observed for alcohol (0·81), iodine (0·79) and folate (0·77). The ICC for fat ranged from 0·70 for saturated fats to 0·77 for polyunsaturated fats. The ICC for protein and energy were 0·68 and 0·72, respectively.
The developed FFQ showed good reproducibility to estimate nutrient intakes and warrants the need for validation of the instrument.
Mass shootings account for a small fraction of annual worldwide murders, yet disproportionately affect society and influence policy. Evidence suggesting a link between mass shootings and severe mental illness (i.e. involving psychosis) is often misrepresented, generating stigma. Thus, the actual prevalence constitutes a key public health concern.
We examined global personal-cause mass murders from 1900 to 2019, amassed by review of 14 785 murders publicly described in English in print or online, and collected information regarding perpetrator, demographics, legal history, drug use and alcohol misuse, and history of symptoms of psychiatric or neurologic illness using standardized methods. We distinguished whether firearms were or were not used, and, if so, the type (non-automatic v. semi- or fully-automatic).
We identified 1315 mass murders, 65% of which involved firearms. Lifetime psychotic symptoms were noted among 11% of perpetrators, consistent with previous reports, including 18% of mass murderers who did not use firearms and 8% of those who did (χ2 = 28.0, p < 0.01). US-based mass shooters were more likely to have legal histories, use recreational drugs or misuse alcohol, or have histories of non-psychotic psychiatric or neurologic symptoms. US-based mass shooters with symptoms of any psychiatric or neurologic illness more frequently used semi-or fully-automatic firearms.
These results suggest that policies aimed at preventing mass shootings by focusing on serious mental illness, characterized by psychotic symptoms, may have limited impact. Policies such as those targeting firearm access, recreational drug use and alcohol misuse, legal history, and non-psychotic psychopathology might yield more substantial results.
Maintaining nutritional adequacy contributes to successful ageing. B vitamins involved in one-carbon metabolism regulation (folate, riboflavin, vitamins B6 and B12) are critical nutrients contributing to homocysteine and epigenetic regulation. Although cross-sectional B vitamin intake in ageing populations is characterised, longitudinal changes are infrequently reported. This systematic review explores age-related changes in dietary adequacy of folate, riboflavin, vitamins B6 and B12 in community-dwelling older adults (≥65 years at follow-up). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, databases (MEDLINE, Embase, BIOSIS, CINAHL) were systematically screened, yielding 1579 records; eight studies were included (n 3119 participants, 2–25 years of follow-up). Quality assessment (modified Newcastle–Ottawa quality scale) rated all of moderate–high quality. The estimated average requirement cut-point method estimated the baseline and follow-up population prevalence of dietary inadequacy. Riboflavin (seven studies, n 1953) inadequacy progressively increased with age; the prevalence of inadequacy increased from baseline by up to 22·6 and 9·3 % in males and females, respectively. Dietary folate adequacy (three studies, n 2321) improved in two studies (by up to 22·4 %), but the third showed increasing (8·1 %) inadequacy. Evidence was similarly limited (two studies, respectively) and inconsistent for vitamins B6 (n 559; −9·9 to 47·9 %) and B12 (n 1410; −4·6 to 7·2 %). This review emphasises the scarcity of evidence regarding micronutrient intake changes with age, highlighting the demand for improved reporting of longitudinal changes in nutrient intake that can better direct micronutrient recommendations for older adults. This review was registered with PROSPERO (CRD42018104364).
The Eating Assessment in Toddlers FFQ (EAT FFQ) has been shown to have good reliability and comparative validity for ranking nutrient intakes in young children. With the addition of food items (n 4), we aimed to re-assess the validity of the EAT FFQ and estimate calibration factors in a sub-sample of children (n 97) participating in the Growing Up Milk – Lite (GUMLi) randomised control trial (2015–2017). Participants completed the ninety-nine-item GUMLi EAT FFQ and record-assisted 24-h recalls (24HR) on two occasions. Energy and nutrient intakes were assessed at months 9 and 12 post-randomisation and calibration factors calculated to determine predicted estimates from the GUMLi EAT FFQ. Validity was assessed using Pearson correlation coefficients, weighted kappa (κ) and exact quartile categorisation. Calibration was calculated using linear regression models on 24HR, adjusted for sex and treatment group. Nutrient intakes were significantly correlated between the GUMLi EAT FFQ and 24HR at both time points. Energy-adjusted, de-attenuated Pearson correlations ranged from 0·3 (fibre) to 0·8 (Fe) at 9 months and from 0·3 (Ca) to 0·7 (Fe) at 12 months. Weighted κ for the quartiles ranged from 0·2 (Zn) to 0·6 (Fe) at 9 months and from 0·1 (total fat) to 0·5 (Fe) at 12 months. Exact agreement ranged from 30 to 74 %. Calibration factors predicted up to 56 % of the variation in the 24HR at 9 months and 44 % at 12 months. The GUMLi EAT FFQ remained a useful tool for ranking nutrient intakes with similar estimated validity compared with other FFQ used in children under 2 years.
The 2017 solar eclipse was associated with mass gatherings in many of the 14 states along the path of totality. The Kentucky Department for Public Health implemented an enhanced syndromic surveillance system to detect increases in emergency department (ED) visits and other health care needs near Hopkinsville, Kentucky, where the point of greatest eclipse occurred.
EDs flagged visits of patients who participated in eclipse events from August 17–22. Data from 14 area emergency medical services and 26 first-aid stations were also monitored to detect health-related events occurring during the eclipse period.
Forty-four potential eclipse event-related visits were identified, primarily injuries, gastrointestinal illness, and heat-related illness. First-aid stations and emergency medical services commonly attended to patients with pain and heat-related illness.
Kentucky’s experience during the eclipse demonstrated the value of patient visit flagging to describe the disease burden during a mass gathering and to investigate epidemiological links between cases. A close collaboration between public health authorities within and across jurisdictions, health information exchanges, hospitals, and other first-response care providers will optimize health surveillance activities before, during, and after mass gatherings.
Insomnia is a risk factor (odds ratio 39,8) as well as symptom of depressive disorder and other psychiatric conditions. Therefore, psychiatrists require appropriate training in diagnosing and treating insomnia. To date, there is no data available in Europe on training in sleep medicine for early career psychiatrists.
To establish how accessible training in insomnia management is to European early career Psychiatrists, and how confident they feel in treating this disorder.
Europe wide survey carried out jointly by the European and World Psychiatric Associations Early Career Psychiatrists Committees. Representatives of Early career Psychiatrists from each participating European country filled in a questionnaire about training in sleep medicine in their country. Early Career Psychiatrists were also invited to fill out a questionnaire at the EPA congress in Nice in 2013.
55 participants from 27 European countries responded. Only 24% had sleep medicine training mandatorily included in their national training curriculum. A majority (60%) felt that the quality of training they did receive was either average or below average. 88% felt either very or fairly confident in treating insomnia. However, when asked to select the correct management options for insomnia from a provided list of 6 options, only 19% and 33% of respondents chose the two correct options.
There is a clear gap between the level of confidence and the clinical judgements being made to treat insomnia among European Early Career Psychiatrists. There is a definite need to improve the availability and structure of insomnia training in Europe.
Dietary patterns describe the combination of foods and beverages in a diet and the frequency of habitual consumption. Better understanding of childhood dietary patterns and antenatal influences could inform intervention strategies to prevent childhood obesity. We derived empirical dietary patterns in 1142 children (average age 6·0 (sd 0·2) years) in New Zealand, whose mothers had participated in the Screening for Pregnancy Endpoints (SCOPE) cohort study and explored associations with measures of body composition. Participants (Children of SCOPE) had their diet assessed by FFQ, and dietary patterns were extracted using factor analysis. Three distinct dietary patterns were identified: ‘Healthy’, ‘Traditional’ and ‘Junk’. Associations between dietary patterns and measures of childhood body composition (waist, hip, arm circumferences, BMI, bioelectrical impedance analysis-derived body fat % and sum of skinfold thicknesses (SST)) were assessed by linear regression, with adjustment for maternal influences. Children who had higher ‘Junk’ dietary pattern scores had 0·24 (sd 0·08; 95 % CI 0·04, 0·13) cm greater arm and 0·44 (sd 0·05; 95 % CI 0·01, 0·10) cm greater hip circumferences and 1·13 (sd 0·07; 95 % CI 0·03, 0·12) cm greater SST and were more likely to be obese (OR 1·74; 95 % CI 1·07, 2·82); those with higher ‘Healthy’ pattern scores were less likely to be obese (OR 0·62; 95 % CI 0·39, 1·00). In a large mother–child cohort, a dietary pattern characterised by high-sugar and -fat foods was associated with greater adiposity and obesity risk in children aged 6 years, while a ‘Healthy’ dietary pattern offered some protection against obesity. Targeting unhealthy dietary patterns could inform public health strategies to reduce the prevalence of childhood obesity.
This paper examines the joint impact of infrastructure capital and institutional quality on economic growth using a large panel dataset covering 99 countries and spanning the years 1980–2015. The empirical strategy involves estimating a simple growth model where, in addition to standard controls, infrastructure, institutional quality, and their interaction are included as explanatory variables. Potential endogeneity concerns are addressed by employing generalized method of moments estimators that utilize internal instruments. We find that the interaction terms between infrastructure capital and institutional quality show a positive and significant impact on economic growth. These results are robust to a variety of alternative specifications and institutional quality measures. Hence, our results suggest that maximizing returns from infrastructure capital requires improving the quality of institutions.
This chapter examines the role of selection in driving certain aspects of pelvic morphology, particularly the differences between mediolateral breadths and anteroposterior breadths. The chapter is divided into three sections, representing the three key selection pressures researchers have spent the most time on – namely, obstetrics, locomotion and thermoregulation. Data for the role of each of these on pelvic morphology are considered, as is discussion of the myriad ways human populations have mixed and matched morphological traits to manage these selection pressures. Clearly, there is not a single strategy for handling the interactive nature of these pressures.
In this chapter, we discuss evidence about the evolutionary forces that have shaped the evolution of the human pelvis, both in its entirety as well as portions of the pelvis, focusing on studies that have investigated pelvic evolution using experimental and quantitative genetic methods. These methods are tied to information from Chapter 4 about pelvis development, with emphasis placed on the importance of understanding the difficulty of tying development and growth with evolutionary processes. Special attention is placed on the concept of the palimpsest. Further, we review these findings in light of three principal hypotheses broadly offered about the processes that selected for pelvic shape (as reviewed in Chapters 2 and 3): locomotion, obstetric sufficiency and thermoregulation. We show from multiple studies that the human pelvis evolved in response to natural selection as well as through neutral evolutionary processes (e.g. genetic drift). A key conclusion from these studies is that parts of the pelvis evolved in different manners in response to these (and other) selection factors; thus, the shape of the human pelvis reflects a modular response to various sources of selection.
This chapter provides an overview of the anatomy of the primate pelvis, with a particular focus on the features of the hominoid (ape) and human pelvic morphologies. Underlying sources of morphological variation such as phylogenetic signals, sexual dimorphism and obstetric function are examined, as well as general patterns of pelvic anatomical variation within Homo sapiens.
In light of the various sources of evidence presented in the preceding chapters, we are left to conclude that the human (in the broadest sense of recent humans and their ancestors) pelvis represents various experiments in evolution. A diversity in pelvic sizes and shapes has marked hominin history, as each population and each species responded to selection pressures in sometimes unique and sometimes convergent ways. These were situated in the distinctive population histories of each of these groups, creating a mosaic of patterns underlain both by responses to evolution and changing patterns of covariance within development. To understand the diversity we observe among fossils, as well as variation within recent humans, we must therefore cultivate a multidisciplinary expertise in biomechanics, kinematics, fossil evidence, developmental biology and evolutionary theory. This book represents an attempt at bringing together these various sources of evidence to better understand the factors, patterns and potential processes that shaped the evolution of the pelvis.
Even before the focus on bipedalism as the ‘hallmark’ of the human lineage (Robinson, 1972), interest in the pelvis was stimulated by discussions across different disciplines, including the growing field of obstetrics (see review in Walrath, 2003), as well as by multiple fossil discoveries (Pycraft, 1930; Dart, 1949). It was also clear at the outset that the pelvis was going to serve as a crucial part of the evolutionary history of humans, given that it had obvious functional implications in its role in locomotion, which included dramatic differences between other species grouped with humans taxonomically and then phylogenetically, including the African and Asian apes.