To investigate the symptoms of SARS-CoV-2 infection, their dynamics and their discriminatory power for the disease using longitudinally, prospectively collected information reported at the time of their occurrence. We have analysed data from a large phase 3 clinical UK COVID-19 vaccine trial. The alpha variant was the predominant strain. Participants were assessed for SARS-CoV-2 infection via nasal/throat PCR at recruitment, vaccination appointments, and when symptomatic. Statistical techniques were implemented to infer estimates representative of the UK population, accounting for multiple symptomatic episodes associated with one individual. An optimal diagnostic model for SARS-CoV-2 infection was derived. The 4-month prevalence of SARS-CoV-2 was 2.1%; increasing to 19.4% (16.0%–22.7%) in participants reporting loss of appetite and 31.9% (27.1%–36.8%) in those with anosmia/ageusia. The model identified anosmia and/or ageusia, fever, congestion, and cough to be significantly associated with SARS-CoV-2 infection. Symptoms’ dynamics were vastly different in the two groups; after a slow start peaking later and lasting longer in PCR+ participants, whilst exhibiting a consistent decline in PCR- participants, with, on average, fewer than 3 days of symptoms reported. Anosmia/ageusia peaked late in confirmed SARS-CoV-2 infection (day 12), indicating a low discrimination power for early disease diagnosis.

There is increasing interest in potential harmful effects of mindfulness-based interventions. In relation to psychosis, inconsistency and shortcomings in how harm is monitored and reported are holding back our understanding. We offer eight recommendations to help build a firmer evidence base on potential harm in mindfulness for psychosis.

Background: There is an emerging evidence base that mindfulness for psychosis is a safe and effective intervention. However, empirical data on the within-session effects of mindfulness meditation was hitherto lacking. Aims: The aim of the study was to assess the impact of taking part in a mindfulness for psychosis group, using a within-session self-report measure of general stress, and symptom-related distress. Method: Users of a secondary mental health service (n = 34), who experienced enduring psychotic symptoms, took part in an 8-week mindfulness for psychosis group in a community setting. Mindfulness meditations were limited to 10 minutes and included explicit reference to psychotic experience arising during the practice. Participants self-rated general stress, and symptom-related distress, before and after each group session using a visual analogue scale. Results: Average ratings of general stress and symptom-related distress decreased from pre- to post-session for all eight sessions, although not all differences were statistically significant. There was no increase in general stress, or symptom-related distress across any session. Conclusions: There was evidence of positive effects and no evidence of any harmful effects arising from people with psychotic symptoms taking part in a mindfulness for psychosis session.

Mindfulness treatments and research have burgeoned over the past decade. With psychosis, progress has been slow and likely held back by clinicians' belief that mindfulness may be harmful for this client group. There is emerging evidence that mindfulness for psychosis – when used in an adapted form – is safe and therapeutic.

Reservoir storage projects are known to alter significantly the environmental settings in which they are established. Extensive data are required to assess quantitatively the physical effects of human interference with rivers. Methodologies must be developed to permit continual monitoring of such changes, so that environmental effects of storage projects may be considered in more integrated, comprehensive plans than hitherto for future river-development efforts.

This study documents stream-channel changes over a five-years period following reservoir completion at eight cross-sections on the main stream below a dam and on one tributary. Of eight main-stream sections, four are increasing in cross-sectional area, namely numbers one, five, six, and seven. Of these, the crosssectional area of numbers one and seven is increasing laterally and that of five and six is increasing vertically. The average annual degradation of sections five and six is 0.092 m over the study period, compared with an average of 0.031 m in the United States over the first 10–15 years after dam closure. Sections three, eight, and nine, are shitfing laterally without a crosssectional area increase, while of sections 2 and 4 the cross-sectional area remained largely unchanged.

Extraction of most of the sediment load by the new reservoir led to increased erosion of the stream channel below the dam. However, it is not always predictable whether the increased erosive power of released clearwater will induce the ongoing channel to erode its bed, widen its section, or cause the bed to move laterally. Nearly all of the nine Deer Creek study sections experienced one of these changes over the study period of five years.

Background: There is a small body of research indicating that mindfulness training can be beneficial for people with distressing psychosis. What is not yet clear is whether mindfulness effects change in affect and cognition associated with voices specifically. This study examined the hypothesis that mindfulness training alone would lead to change in distress and cognition (belief conviction) in people with distressing voices. Method: Two case studies are presented. Participants experienced long-standing distressing voices. Belief conviction and distress were measured twice weekly through baseline and mindfulness intervention. Mindfulness in relation to voices was measured at the start of baseline and end of intervention. Results: Following a relatively stable baseline phase, after 2–3 weeks of mindfulness practice, belief conviction and distress fell for both participants. Both participants' mindfulness scores were higher post treatment. Conclusion: Findings show that mindfulness training has an impact on cognition and affect specifically associated with voices, and thereby beneficially alters relationship with voices.

Background: The clinical literature cautions against use of meditation by people with psychosis. There is, however, evidence for acceptance-based therapy reducing relapse, and some evidence for clinical benefits of mindfulness groups for people with distressing psychosis, though no data on whether participants became more mindful. Aims: To assess feasibility of randomized evaluation of group mindfulness therapy for psychosis, to replicate clinical gains observed in one small uncontrolled study, and to assess for changes in mindfulness. Method: Twenty-two participants with current distressing psychotic experiences were allocated at random between group-based mindfulness training and a waiting list for this therapy. Mindfulness training comprised twice-weekly sessions for 5 weeks, plus home practice (meditation CDs were supplied), followed by 5 weeks of home practice. Results: There were no significant differences between intervention and waiting-list participants. Secondary analyses combining both groups and comparing scores before and after mindfulness training revealed significant improvement in clinical functioning (p = .013) and mindfulness of distressing thoughts and images (p = .037). Conclusions: Findings on feasibility are encouraging and secondary analyses replicated earlier clinical benefits and showed improved mindfulness of thoughts and images, but not voices.

Five 18 week skills training groups based on Dialectical Behaviour Therapy (DBT) were provided for 34 participants with parasuicidal behaviours; 26 participants completed the programme. Monthly support/education groups for their keyworkers were also provided. Inpatient admissions decreased by 30% and out-patient appointments for those without admission by 61% over the 18 months from the initial pre-group formulation meeting, compared with the preceding 18 months. Statistical analysis (N = 17) showed significant reduction in CORE scores over the intervention period, and a similar effect in scores on the Work and Social Adjustment Scale. User satisfaction was high and drop out low (23.5%). Results indicate DBT skills group might be a useful service where full DBT is unavailable.

Nutrigenomics is the study of how constituents of the diet interact with genes, and their products, to alter phenotype and, conversely, how genes and their products metabolise these constituents into nutrients, antinutrients, and bioactive compounds. Results from molecular and genetic epidemiological studies indicate that dietary unbalance can alter gene–nutrient interactions in ways that increase the risk of developing chronic disease. The interplay of human genetic variation and environmental factors will make identifying causative genes and nutrients a formidable, but not intractable, challenge. We provide specific recommendations for how to best meet this challenge and discuss the need for new methodologies and the use of comprehensive analyses of nutrient–genotype interactions involving large and diverse populations. The objective of the present paper is to stimulate discourse and collaboration among nutrigenomic researchers and stakeholders, a process that will lead to an increase in global health and wellness by reducing health disparities in developed and developing countries.

The study's objective was to assess the impact on clinical functioning of group based mindfulness training alongside standard psychiatric care for people with current, subjectively distressing psychosis. Data are presented from the first 10 people to complete one of four Mindfulness Groups, each lasting six sessions. People were taught mindfulness of the breath, and encouraged to let unpleasant experiences come into awareness, to observe and note them, and let them go without judgment, clinging or struggle. There was a significant pre-post drop in scores on the CORE (z=−2.655, p=.008). Secondary data indicated improvement in mindfulness skills, and the subjective importance of mindfulness to the group process (N=11). The results are encouraging and warrant further controlled outcome and process research.

Greenberg, Rice and Elliott (1993) elaborate in detail different applications of the two-chair method within an experiential therapy framework. In the present paper we present an adapted two-chair method for use in cognitive therapy. The principal aims of the adapted method are to elaborate a positive self-schema that has an emotional (“lived”) quality, and to use this experience to create a new model of self as emotionally and cognitively varied and changing. Procedurally, the first two steps are to (1) summarize the negative self-schema (Chair 1) and (2) draw out a positive self-schema (Chair 2). In Steps 3 and 4 the client remains in Chair 2 and is encouraged to accept the two self-schemata, and to integrate them both within a broader, more diverse metacognitive model of self. We present key themes from analysis of two clients' reflections on the method, which highlight issues of generalization and the process of change, and conclude with clinical and research implications.

When does a therapeutic intervention become an accepted part of standard clinical practice? Is it when there is sufficient research evidence? But what constitutes ‘sufficient’? What about available resources and acceptability to patients? Do we have to wait until the National Institute for Clinical Excellence pronounces? A convincing evidence base for family work in schizophrenia (Kuipers, 2000) has existed for many years but has been poorly implemented (Anderson & Adams, 1996). Will cognitive-behavioural therapy (CBT) for psychosis suffer the same fate? Which professional group will champion such an implementation? The evidence for other psychological treatments is less robust. Psychoeducation may prolong time to relapse and improve insight but at the cost of increasing suicidal ideation (Carroll et al, 1998). Personal therapy (Hogarty et al, 1997) may be of value but is contra-indicated for patients who are living alone in the community. Psychodynamic approaches are advocated (Mace & Margison, 1997) but most psychiatrists do not support their use in practice, owing to lack of evidence of efficacy.