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Although there is growing interest in mental health problems in university students there is limited understanding of the scope of need and determinants to inform intervention efforts.
To longitudinally examine the extent and persistence of mental health symptoms and the importance of psychosocial and lifestyle factors for student mental health and academic outcomes.
Undergraduates at a Canadian university were invited to complete electronic surveys at entry and completion of their first year. The baseline survey measured important distal and proximal risk factors and the follow-up assessed mental health and well-being. Surveys were linked to academic grades. Multivariable models of risk factors and mental health and academic outcomes were fit and adjusted for confounders.
In 1530 students surveyed at entry to university 28% and 33% screened positive for clinically significant depressive and anxiety symptoms respectively, which increased to 36% and 39% at the completion of first year. Over the academic year, 14% of students reported suicidal thoughts and 1.6% suicide attempts. Moreover, there was persistence and overlap in these mental health outcomes. Modifiable psychosocial and lifestyle factors at entry were associated with positive screens for mental health outcomes at completion of first year, while anxiety and depressive symptoms were associated with lower grades and university well-being.
Clinically significant mental health symptoms are common and persistent among first-year university students and have a negative impact on academic performance and well-being. A comprehensive mental health strategy that includes a whole university approach to prevention and targeted early-intervention measures and associated research is justified.
A basic tenet of ecotourism is to enhance conservation. However, few studies have assessed its effectiveness in meeting conservation goals and whether the type of tourism activity affects outcomes. This study examines whether working in ecotourism changes the perceptions of and attitudes and behaviours of local people towards the focal species and its habitat and, if so, if tourism type affects those outcomes. We interviewed 114 respondents at four whale shark Rhincodon typus tourism sites in the Philippines to compare changes in perceptions of and attitudes and behaviours towards whale sharks and the wider marine environment. We found that the smaller scale tourism sites had greater social conservation outcomes than the mass or failed tourism sites, including changes in conservation ethics and perceptions of and attitudes and behaviours towards whale sharks and the ocean. Furthermore, of the three active tourism sites, the smallest site, with the lowest economic returns and the highest negative impacts on whale sharks prior to tourism activities, had the largest proportion of respondents who reported a positive change in perceptions of and attitudes and behaviours towards whale sharks and the ocean. Our results suggest that tourism type, and the associated incentives, can have a significant effect on conservation outcomes and ultimately on the ecological status of an Endangered species and its habitat.
Les troubles dépressifs concernent près de deux fois plus de femmes que d’hommes . Cette prévalence pourrait être due à une sensibilité accrue des femmes aux émotions négatives . Peu d’études d’imagerie cérébrale ont comparé l’activité cérébrale des hommes et des femmes lors de la présentation de stimuli émotionnels.
Objectif et hypothèse
Notre objectif était d’étudier les activations cérébrales des hommes et des femmes lors d’une tâche émotionnelle. Nous avons émis l’hypothèse que le pattern d’activations cérébrales diffère selon le sexe des individus et la valence des stimuli.
Nous avons mené une étude en imagerie par résonance magnétique fonctionnelle (IRMf) chez 30 participants sains (15 hommes et 15 femmes). Des stimuli à valence positive, négative et neutre étaient présentés aux sujets. Les participants ont évalué subjectivement la valence et l’intensité des stimuli.
Nous observons une activité plus importante chez les femmes que chez les hommes dans plusieurs régions clés du traitement des émotions lors de la présentation de stimuli négatifs. Aucune différence significative entre les hommes et les femmes n’a été relevée concernant l’évaluation subjective des stimuli en termes de valence et d’intensité.
Les résultats suggèrent qu’il existe bien une différence de patterns d’activation entre les hommes et les femmes lors de la perception des émotions négatives, qui irait dans le sens d’une sensibilité accrue chez les femmes. Celle-ci pourrait expliquer leur plus grande vulnérabilité aux troubles dépressifs. Il pourrait être intéressant de répliquer cette étude chez des patients qui souffrent de troubles de l’humeur.
La rTMS est une technique non invasive modulant l’excitabilité corticale. Elle peut améliorer les performances mnésiques des patients âgés souffrant de troubles cognitifs. L’objectif est de présenter l’évolution des fonctions mnésiques de patients traités par rTMS. Sujet 1 : 73 ans, patient inclus dans une étude ayant pour but d’évaluer l’impact de la rTMS sur les troubles cognitifs. Le critère principal est l’évolution de la MoCA.
Stimulation du cortex préfrontal dorso-latéral droit à 1 Hz. Le patient reçoit 20 séances sur 4 semaines, 8 séances le 2e mois, 4 séances le 3e mois puis 6 séances les 3 derniers mois.
MoCA pré-inclusion : 25/30. Augmentation progressive jusqu’à M6 pour atteindre 30/30 puis diminution entre M6 et M12 jusqu’à 27/30. Sujet 2 : 81 ans, patient atteint de la maladie d’Alzheimer depuis 5 ans, traité par Donepezil. Méthode : protocole iTBS, 600 pulses, sur cortex dorso-latéral préfrontal gauche, à 80 % du seuil moteur gauche. Quarante séances sur 4 semaines. Le MMSE initial est de 16/30. Le MMSE post-rTMS immédiat s’élève à 20/30 et le MMSE à 3 mois à 24/30. Sujet 3 : 73 ans, patiente présentant des plaintes mnésiques à type d’atteinte isolée de la mémoire épisodique verbale. Elle est traitée par Duloxétine 30 mg/j et Rivastigmine patch 4,6 mg/. Méthode : 30 séances d’iTBS, 600 pulses, à 80 % du seuil moteur appliqué sur le cortex dorso-latéral préfrontal gauche, sur 3 semaines, répétée à M3. La MoCA pré-stimulation est à 15/30 et augmente à 19/30 après la seconde série.
La rTMS a montré des résultats positifs et encourageants pouvant être une piste pour la future prise en charge des troubles mnésiques chez le sujet âgé.
La stimulation magnétique transcrânienne répétitive (SMTr) appliquée sur le cortex préfrontal dorso-latéral (CPFDL) a prouvé son efficacité dans le traitement de la dépression résistante . En plus d’une amélioration sur la symptomatologie, des études rapportent des effets positifs sur le fonctionnement cognitif , dont la mémoire de travail. Cependant, cet effet ne semble pas être retrouvé chez des sujets sains  lors d’une tâche de N-back sans leurre. L’objectif de notre étude est donc d’évaluer l’impact de la SMTr sur le CPFDL, région plus sensible à une tâche de N-back avec leurre .
Une étude randomisée en double insu a été menée chez 30 participants sains. Une stimulation de type iTBS (intermittent theta burst stimulation) a été effectuée pendant 5 jours à raison de 2 séances/jour appliquée au niveau du CPFDL gauche ciblé par neuro-navigation sur les coordonnées MNI (X, Y, Z = –50,30,36). Nous avons observé l’impact de la SMTr sur le comportement des participants durant la tâche de N-back. Pour cela, les participants ont effectué cette tâche, composée de blocs de 0-back, 3-back et 3-back contenant des leurres, lors de deux sessions d’IRMf (une avant et une après la semaine de stimulation active ou placebo). La performance, le temps de réaction ainsi que les données d’imageries ont été recueillis.
Les 2 groupes ne montrent pas de différence au niveau de l’âge ou du genre. Au niveau comportemental, les premières analyses sur la performance ainsi que sur le temps de réaction ne montrent pas d’effet d’interaction Groupe (actif/placebo) * Temps (avant/après SMTr). Au niveau des données de neuro-imagerie, une analyse d’interaction Groupe * Temps en prenant en compte la condition leurre nous permettra de mieux comprendre l’impact de la SMTr sur la mémoire de travail impliquant le CPFDL.
Psychiatric morbidity was assessed in 55 HIV seropositive women who were attending either an HIV centre in Paris (n = 30) or a genitourinary clinic in London (n = 25). Demographic data and information concerning HIV disease, openness about diagnosis, counselling received, social and family support, sexual behaviour and attitudes towards fertility and pregnancy were recorded using a semi-structured interview. Moderate or severe levels of psychiatric distress were found in 60% of the women in Paris and 28% of those in London. Overall, these rates are higher than those found in comparable studies of HIV seropositive men. Psychiatric disorder was associated with a past history of intravenous drug use and older age. Over half of the women were in regular sexual relationships but safe sex precautions were frequently not used. Sixteen subjects among those of child bearing age were prepared to consider having children.
Le source monitoring se caractérise par la capacité à distinguer l’origine d’une information qu’elle soit autogénérée ou provenant d’une source extérieure. Ces capacités semblent être altérées dans la schizophrénie et d’autant plus chez des sujets présentant une symptomatologie positive. Les hypothèses de recherche actuelles suggèrent qu’un déficit de source monitoring pourrait expliquer la présence de symptômes positifs et plus particulièrement d’hallucinations auditives. Dans la schizophrénie, ce lien a été mis en évidence par un certain nombre d’auteurs [1,3]. Brunelin et al.  ont montré une amélioration significative des capacités de source monitoring corrélée à une baisse des hallucinations auditives chez des sujets schizophrènes traités par stimulation magnétique transcrânienne (TMS). L’objectif de notre étude est d’évaluer les déficits de source monitoring de sujets schizophrènes présentant des hallucinations auditives résistantes et de volontaires sains traités par TMS. Nous avons inclus 20 sujets schizophrènes présentant des hallucinations résistantes et 20 volontaires sains traités par TMS en double aveugle. La symptomatologie a été évaluée par la PANSS et l’échelle d’hallucinations auditives de Hoffmann concernant le groupe de sujets schizophrènes. Les volontaires ont été évalués avec l’échelle de Hamilton et la MINI 500. Une tâche de mémoire de la source était administrée, avant et après le traitement par TMS, dans les deux groupes. Elle se présente sous la forme de deux tests : « Dire » permettant d’évaluer les capacités de reconnaissance de mots produits par le sujet, et un test « Entendre » permettant de distinguer des informations provenant de soi ou d’une source extérieure. Cette tâche est suivie d’une phase de reconnaissance durant laquelle le sujet doit se rappeler de la source correcte des mots qui lui ont été présentés parmi une liste de mots comprenant des distracteurs. Les résultats mettent en évidence un effet non délétère de la TMS sur les performances à la tâche de source monitoring.
Advance statements are expressions of wishes made by an individual anticipating future mental incapacity to express treatment choices, spiritual or cultural needs and to nominate someone to be consulted in the event of future incapacity.Advance statements about medical treatment are usually positively-framed treatment choices or requests. An advance statement could also inform the process of determining a person's best interests under the Mental Capacity Act 2005 procedure. Advance Directives project was initiated at Langdon Hospital(Regional Secure Unit with medium and low secure as well as open Forensic wards) in early 2011 and rolled out across site by late 2011.
Aims and objectives:
To audit the opportunity for patients at Langdon Hospital to have Advance Statements in place and its recording on Rio electronic system.To find out areas within the procedure that need improvement and changes.
Data was collected from Rio electronic records of all patients of all wards at Langdon Hospital during a 3 week period.
Results and conclusions:
Most wards had offered above 80% of patients a chance to make Advance Statements. 2 wards achieved 100%. The uptake by patients who were offered an opportunity was high at 70%. Most patients prefer to have a named advocate.In some cases patients specifically asked for a relative not to be involved.Improvement needed in using recommended format and uploading it to Rio. Some staff were concentrating mainly on physical health/end of life decisions. Improvement needed in including questions related to management of future aggression and violence.
With one in ten young people being affected by ill mental health and stigma regularly cited as a factor affecting access to early intervention services, focussing resources on school based stigma reduction strategies seems prudent. ‘Headucate’, a student society, designed a 50 minute workshop which aims to increase mental health literacy and decrease stigma.
Repeated, cross sectional surveys were carried out at three time points; 1) immediately before (n=77), 2) Immediately after (n=81) and 3) three months post workshop (n=73). The surveys were paper based versions of the Reported Intended Behaviours Score (RIBS) and Mental Health Knowledge Scale (MAKS) utilising a social distance scale.
Four year 10 classed (pupils aged 14-15) were recruited. Post hoc t-tests were carried out when one-way ANOVAS were significant.
Disorder knowledge (from MAKS) and intended contact (from RIBS) significantly increased between time points one and two (p<0.01 and <0.004 respectively) but then decreased.
Analysis of the question pertaining to knowing where to access help showed a statistically significant increase (p<0.001) between time points one and two and then a decrease at time three, albeit to a higher value than at time point one (3.45 compared to 3.13, P=0.088).
Headucate workshops offer a low resource option which is well accepted by students. Like other school based stigma reduction strategies, a dramatic increase was seen between immediately before and after indicating that the workshop resonates with the pupils, but there was little sustained change in attitudes.
Tectonic hazards have profoundly influenced Māori relationships with, and understandings of, the environment, with oral histories and ethnographic records referencing recurring encounters with volcanic eruptions, earthquakes, and tsunamis across Aotearoa-New Zealand. This research works alongside members of the Māori kin-group Ngāti Kuri to deliberate and compare active oral histories with two ethnographic records that potentially refer to ancestral experience with past tsunami(s) in the Kaikōura region. It applies an inductive-based methodology informed by “collaborative storytelling,” with the intent to appreciate the manner in which Ngāti Kuri interpret their past and present. The research affirms past catastrophic saltwater inundations and potential tectonic disturbances in the Kaikōura region. It also affirms that ethnographic records are not necessarily full or accurate accounts of historical events. The accounts presented here contribute to the reclaiming of Ngāti Kuri histories and point to new plural learning opportunities about coseismic tsunami hazard and history across the region.
B vitamins involved in one-carbon metabolism have been implicated in the development of inflammation- and angiogenesis-related chronic diseases, such as colorectal cancer (CRC). Yet, the role of one-carbon metabolism in inflammation and angiogenesis among CRC patients remains unclear. The objective of this study was to investigate associations of components of one-carbon metabolism with inflammation and angiogenesis biomarkers among newly diagnosed CRC patients (n 238) in the prospective ColoCare Study, Heidelberg. We cross-sectionally analysed associations between twelve B vitamins and one-carbon metabolites and ten inflammation and angiogenesis biomarkers from pre-surgery serum samples using multivariable linear regression models. We further explored associations among novel biomarkers in these pathways with Spearman partial correlation analyses. We hypothesised that pyridoxal-5’-phosphate (PLP) is inversely associated with inflammatory biomarkers. We observed that PLP was inversely associated with C-reactive protein (CRP) (r –0·33, Plinear < 0·0001), serum amyloid A (SAA) (r –0·23, Plinear = 0·003), IL-6 (r –0·39, Plinear < 0·0001), IL-8 (r –0·20, Plinear = 0·02) and TNFα (r –0·12, Plinear = 0·045). Similar findings were observed for 5-methyl-tetrahydrofolate and CRP (r –0·14), SAA (r –0·14) and TNFα (r –0·15) among CRC patients. Folate catabolite acetyl-para-aminobenzoylglutamic acid (pABG) was positively correlated with IL-6 (r 0·27, Plinear < 0·0001), and pABG was positively correlated with IL-8 (r 0·21, Plinear < 0·0001), indicating higher folate utilisation during inflammation. Our data support the hypothesis of inverse associations between PLP and inflammatory biomarkers among CRC patients. A better understanding of the role and inter-relation of PLP and other one-carbon metabolites with inflammatory processes among colorectal carcinogenesis and prognosis could identify targets for future dietary guidance for CRC patients.
Nearly half of care home residents with advanced dementia have clinically significant agitation. Little is known about costs associated with these symptoms toward the end of life. We calculated monetary costs associated with agitation from UK National Health Service, personal social services, and societal perspectives.
Prospective cohort study.
Thirteen nursing homes in London and the southeast of England.
Seventy-nine people with advanced dementia (Functional Assessment Staging Tool grade 6e and above) residing in nursing homes, and thirty-five of their informal carers.
Data collected at study entry and monthly for up to 9 months, extrapolated for expression per annum. Agitation was assessed using the Cohen-Mansfield Agitation Inventory (CMAI). Health and social care costs of residing in care homes, and costs of contacts with health and social care services were calculated from national unit costs; for a societal perspective, costs of providing informal care were estimated using the resource utilization in dementia (RUD)-Lite scale.
After adjustment, health and social care costs, and costs of providing informal care varied significantly by level of agitation as death approached, from £23,000 over a 1-year period with no agitation symptoms (CMAI agitation score 0–10) to £45,000 at the most severe level (CMAI agitation score >100). On average, agitation accounted for 30% of health and social care costs. Informal care costs were substantial, constituting 29% of total costs.
With the increasing prevalence of dementia, costs of care will impact on healthcare and social services systems, as well as informal carers. Agitation is a key driver of these costs in people with advanced dementia presenting complex challenges for symptom management, service planners, and providers.
We clarify the theoretical foundations of partisan fairness standards for district-based democratic electoral systems, including essential assumptions and definitions not previously recognized, formalized, or in some cases even discussed. We also offer extensive empirical evidence for assumptions with observable implications. We cover partisan symmetry, the most commonly accepted fairness standard, and other perspectives. Throughout, we follow a fundamental principle of statistical inference too often ignored in this literature—defining the quantity of interest separately so its measures can be proven wrong, evaluated, and improved. This enables us to prove which of the many newly proposed fairness measures are statistically appropriate and which are biased, limited, or not measures of the theoretical quantity they seek to estimate at all. Because real-world redistricting and gerrymandering involve complicated politics with numerous participants and conflicting goals, measures biased for partisan fairness sometimes still provide useful descriptions of other aspects of electoral systems.
Structural characterization and X-ray reference powder pattern determination have been conducted for the Co- and Zn-containing tridymite derivatives Ba(Co1−xZnx)SiO4 (x = 0.2, 0.4, 0.6, 0.8). The bright blue series of Ba(Co1−xZnx)SiO4 crystallized in the hexagonal P63 space group (No. 173), with Z = 6. While the lattice parameter “a” decreases from 9.126 (2) Å to 9.10374(6) Å from x = 0.2 to 0.8, the lattice parameter “c” increases from 8.69477(12) Å to 8.72200(10) Å, respectively. Apparently, despite the similarity of ionic sizes of Zn2+ and Co2+, these opposing trends are due to the framework tetrahedral tilting of (ZnCo)O4. The lattice volume, V, remains comparable between 626.27 Å3 and 626.017 (7) Å3 from x = 0 to x = 0.8. UV-visible absorption spectrum measurements indicate the band gap of these two materials to be ≈3.3 and ≈3.5 eV, respectively, therefore potential UV photocatalytic materials. Reference powder X-ray diffraction patterns of these compounds have been submitted to be included in the Powder Diffraction File (PDF).
The majority of New Zealand dairy goat farmers utilise cultivated green-fed fodder dominated by perennial ryegrass (Lolium perenne L.) and white clover (Trifolium repens L.), but evidence from other ruminant species suggests that milk production may be improved when using a more diverse array of species within the green fodder. The aim of this experiment was to determine whether feeding lactating dairy goats a mixed-species green fodder (MF, consisting of perennial ryegrass, timothy (Phleum pratense L.), prairie grass (Bromus willdenowii Kunth), white clover, red clover (Trifolium pratense L.), lucerne (Medicago sativa L.), chicory (Cichorium intybus L.) and plantain (Plantago lanceolata L.) improves dietary intake, milk yield and composition compared with a standard ryegrass and white clover green fodder (SF). Thirty-six mid-lactation goats were housed indoors in pairs and split into two groups (A and B). The trial was split into three periods – firstly a uniformity period of 6 days, in which all goats were fed a combination of both green fodder types, followed by two treatment periods (P1 and P2) of 12 days, respectively. For P1, group A was fed MF and group B was fed SF, and then the group diets were switched for P2. Goats fed MF had 13% greater dry matter intake and 7% greater milk yield than goats fed SF. In addition, the milk protein and fat concentration of goats fed MF were 4% greater than for those fed SF, whereas there was no effect on milk lactose concentration. There was no treatment effect on the levels of protein, glucose, urea or non-esterified fatty acids in the blood of the goats. An effect of green fodder type on milk fat profile was demonstrated, with proportions of pentadecylic acid (C15:0), cis-vaccenic acid (C18:1 c11), linoleic acid (C18:2 n6) and α-linolenic acid (C18:3 n3) being increased in response to MF consumption. In contrast, iso-C15 and iso-C17 proportions were lesser. In summary, this study demonstrated that goats fed MF increased green fodder intake and milk production compared with goats fed SF. The green fodder type affected the fatty acid profile of goat’s milk, with MF increasing the levels of beneficial polyunsaturated omega fatty acids (linoleic and α-linolenic acids).
Filamentary structures can form within the beam of protons accelerated during the interaction of an intense laser pulse with an ultrathin foil target. Such behaviour is shown to be dependent upon the formation time of quasi-static magnetic field structures throughout the target volume and the extent of the rear surface proton expansion over the same period. This is observed via both numerical and experimental investigations. By controlling the intensity profile of the laser drive, via the use of two temporally separated pulses, both the initial rear surface proton expansion and magnetic field formation time can be varied, resulting in modification to the degree of filamentary structure present within the laser-driven proton beam.
The spatial-intensity profile of light reflected during the interaction of an intense laser pulse with a microstructured target is investigated experimentally and the potential to apply this as a diagnostic of the interaction physics is explored numerically. Diffraction and speckle patterns are measured in the specularly reflected light in the cases of targets with regular groove and needle-like structures, respectively, highlighting the potential to use this as a diagnostic of the evolving plasma surface. It is shown, via ray-tracing and numerical modelling, that for a laser focal spot diameter smaller than the periodicity of the target structure, the reflected light patterns can potentially be used to diagnose the degree of plasma expansion, and by extension the local plasma temperature, at the focus of the intense laser light. The reflected patterns could also be used to diagnose the size of the laser focal spot during a high-intensity interaction when using a regular structure with known spacing.
Up to 70 per cent of the population search online for medical or health-related information. This study aimed to assess the quality of online health resources available to educate patients on a variety of otolaryngological conditions.
Two clinicians independently analysed the quality and content of educational websites (patient.co.uk and wikipedia.org) for common and uncommon diagnoses, with cancerresearchuk.org also used to assess two head and neck cancers.
Cancerresearchuk.org, followed by patient.co.uk, scored most highly in their ability to inform readers on a selection of otolaryngological conditions. Although wikipedia.org was less likely to include all relevant information and was more difficult to read, it still provided mostly accurate information.
Where possible, patients should be advised to access professionally maintained health information websites (patient.co.uk and cancerresearchuk.org). However, wikipedia.org can provide adequate information, although it lacks depth and can be difficult to understand.
Early life stress (ELS) is a significant risk factor for the emergence of internalizing problems in adolescence. Beginning in adolescence, females are twice as likely as males to experience internalizing disorders. The present study was designed to examine sex differences in the association between ELS and internalizing problems in early pubertal adolescents, and whether and how corticolimbic function and connectivity may underlie these associations. Fifty-nine early pubertal males and 78 early pubertal females, ages 9–13 years (all Tanner Stage 3 or below) underwent functional magnetic resonance imaging as they performed an emotion label task that robustly interrogates corticolimbic function. Participants were also interviewed about their experience of ELS. Females exhibited a positive association between ELS and internalizing problems, whereas males exhibited no such association. Whole-brain and amygdala region of interest analyses indicated that whereas females exhibited a positive association between ELS and the ventrolateral prefrontal cortex during implicit emotion regulation, males showed no such association. Activation in these regions was positively associated with internalizing problems in females but not males; however, activation in these regions did not mediate the association between ELS and internalizing problems. Finally, both boys and girls exhibited an association between ELS and increased negative connectivity between the right ventrolateral prefrontal cortex and bilateral amygdala. Using a carefully characterized sample of early pubertal adolescents, the current study highlights important sex differences in the development of corticolimbic circuitry during a critical period of brain development. These sex differences may play a significant role in subsequent risk for internalizing problems.