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Mental disorders in children and adolescents have an impact on educational attainment.
To examine the temporal association between attainment in education and subsequent diagnosis of depression or self-harm in the teenage years.
General practitioner, hospital and education records of young people in Wales between 1999 and 2014 were linked and analysed using Cox regression.
Linked records were available for 652 903 young people and of these 33 498 (5.1%) developed depression and 15 946 (2.4%) self-harmed after the age of 12 but before the age of 20. Young people who developed depression over the study period were more likely to have achieved key stage 1 (age 7 years) but not key stage 2 (age 11) (hazard ratio (HR) = 0.79, 95% CI 0.74–0.84) milestones, indicating that they were declining in academic attainment during primary school. Conversely, those who self-harmed were achieving as well as those who did not self-harm in primary school, but showed a severe decline in their attainment during secondary school (HR = 0.72, 95% CI 0.68–0.78).
Long-term declining educational attainment in primary and secondary school was associated with development of depression in the teenage years. Self-harm was associated with declining educational attainment during secondary school only. Incorporating information on academic decline with other known risk factors for depression/self-harm (for example stressful life events, parental mental health problems) may improve risk profiling methods.
The efficacy of acceptance and commitment therapy (ACT) in psychosis has been reported but not for medication-resistant psychosis.
To test the efficacy of ACT in a sample of community-residing patients with persisting psychotic symptoms. (Australian New Zealand Clinical Trials Registry: ACTRN12608000210370.)
The primary outcome was overall mental state at post-therapy (Positive and Negative Syndrome Scale –total); secondary outcomes were psychotic symptom dimensions and functioning. In total, 96 patients were randomised to ACT (n = 49) or befriending (n = 47). Symptom, functioning and process measures were administered at baseline, post-therapy and 6 months later.
There was no group difference on overall mental state. In secondary analyses the ACT group showed greater improvement in positive symptoms and hallucination distress at follow-up: Cohen's d = 0.52 (95% CI 0.07–0.98) and 0.65 (95% CI 0.24–1.06), respectively.
Improvements reflected the treatment focus on positive symptoms; however, absence of process-measure changes suggests that the ACT intervention used did not manipulate targeted processes beyond befriending. Symptom-specific therapy refinements, improved investigation of process and attention to cognitive functioning and dose are warranted in future research.
This paper identifies the resource needs of international entrepreneurs and examines the role of government and industry networks as providers of resource opportunities deemed essential by international entrepreneurs for international growth. Unique resource challenges confront international entrepreneurs in their pursuit of international markets. Our qualitative study of Australian entrepreneurs in the health industry reveals that international entrepreneurs emphasise information, knowledge and relational resources as crucial for international market entry. Although government networks provide essential resources at the planning and pre-entry stage of internationalisation, at the postentry stage industry networks offer more relevant resource opportunities. Both networks, however, fall short of expectations in affording knowledge and relational resources that are instrumental in entering international markets.
The canon law dictum that ‘dubius in fide infidelis est’ offers a seemingly definitive statement on the place of doubt and uncertainty in medieval Catholicism. Yet where Catholic teaching was open to question, doubt was inseparable from faith, not merely as its obverse but as part of the process of achieving faithfulness – the trajectory outlined by Abelard in the twelfth century. The challenge for the Church was not that doubters lacked faith, but that having tested their doubts they might end up with the wrong faith: doubt preceded assurance, one way or the other. That problem is addressed in this essay by a broad examination of the ties between faith and doubt across the late Middle Ages (from the twelfth to the sixteenth centuries), arguing that uncertainty and doubt were almost unavoidable in medieval Catholicism. As the starting points in a process which could lead to heresy and despair, they also had a positive role in developing and securing orthodox faith.
Bishop of Urbino Giovanni Pietro Arrivabene selected the foreign saints Thomas Becket and Martin of Tours as patrons for his burial chapel. Montefeltro court artist Timoteo Viti decorated the chapel with the saints’ images, including a fresco of Saint Martin exorcising a demon from a cow. This article argues that the chapel’s unusual, allegorical iconographic program condemns Cesare Borgia’s campaigns to dominate Central Italy. It also proposes that the kneeling figure in the altarpiece’s lower right register portrays the bishop’s heir. Finally, the accomplishment of the Arrivabene chapel demonstrates Timoteo Viti’s artistic independence from his famous colleague and collaborator, Raphael.
To determine rates of parent-reported child awareness of parental depression, examine characteristics of parents, children and families according to child awareness, and explore whether child awareness is associated with child psychopathology. Data were available from 271 families participating in the Early Prediction of Adolescent Depression (EPAD) study, a longitudinal study of offspring of parents with recurrent depression.
Seventy-three per cent of participating children were perceived as being aware of their parent's depression. Older children, and children of parents who experienced more severe depression, were more likely to be aware. Awareness was not associated with child psychopathology.
Considering children in the context of parental depression is important. Child awareness may influence their access to early intervention and prevention programmes. Further research is needed to understand the impact of awareness on the child.
One of the fundamental challenges in understanding the early stages of corrosion pitting in metals protected with an oxide film is that there are relatively few techniques that can probe microstructure with sufficient resolution while maintaining a wet environment. Here, we demonstrate that microstructural changes in Al thin films caused by aqueous NaCl solutions of varying chloride concentrations can be directly observed using a liquid flow cell enclosed within a transmission electron microscope (TEM) holder. In the absence of chloride, Al thin films did not exhibit significant corrosion when immersed in de-ionized water for 2 days. However, introducing 0.01 M NaCl solutions led to extensive random formation of blisters over the sample surface, while 0.1 M NaCl solutions formed anomalous structures that were larger than the typical grain size. Immersion in 1.0 M NaCl solutions led to fractal corrosion consistent with previously reported studies of Al thin films using optical microscopy. These results show the potential of in situ liquid cell electron microscopy for probing the processes that take place before the onset of pitting and for correlating pit locations with the underlying microstructure of the material.
Earlier age of menarche is believed to confer greater vulnerability to depressive symptoms via increased reactivity to stressors associated with adolescence. In this longitudinal study, we measured depressive symptoms and salivary cortisol levels in 198 boys and 142 girls between the ages of 11 and 13 tested four times during Grade 7 as they transitioned from elementary school to secondary school as per Quebec's education system. Results showed that girls who had already reached menarche before starting secondary school had significantly higher depressive symptoms and salivary cortisol levels across the school year in comparison to girls who had not reached menarche, who in turn presented higher depressive scores than boys. When we divided menarcheal girls as a function of menarcheal timing in subanalyses, we found that girls with early menarche presented consistently elevated depressive symptoms across the school year while girls with on-time menarche presented transient depressive symptoms but no differences in salivary cortisol levels. Collectively, these results show that early menarche is associated with high depressive symptoms and cortisol levels in adolescent girls. This developmental milestone may render girls more vulnerable to environmental stressors and therefore represents a critical period to intervene to promote mental health.
Tsunamis and storms instigate sedimentological and geomorphological changes to the coastal system, both long-term and ephemeral. To accurately predict future coastal hazards, one must identify the records that are generated by the processes associated with these hazards and recognize what will be preserved. Using eyewitness accounts, photographs, and sedimentology, this study documents pre- and post-tsunami conditions and constrains the timing and process of depositional events during and following the 11 March 2011 Tohoku tsunami in the coastal system at El Garrapatero, Galapagos Islands. While the tsunami acted as both an erosional and depositional agent, the thick, fan-like sand sheet in El Garrapatero was primarily emplaced by overwash deposition during high tide from swell waves occurring between 19–25 March and 17–22 April 2011. The swell waves were only able to access the terrestrial coastal system via a channel carved by the 2011 Tohoku tsunami through the barrier sand dune. This combined deposit could result in an overestimation of the hazard if interpreted to be the result of only one event (either tsunami or wind-generated waves). An analogous sand layer, younger than 1390–1530 calyr BP, may record a similar, prior event.
Offspring of mothers with depression are at heightened risk of psychiatric disorder. Many mothers with depression have comorbid psychopathology. How these co-occurring problems affect child outcomes has rarely been considered.
To consider whether the overall burden of co-occurring psychopathology in mothers with recurrent depression predicts new-onset psychopathology in offspring.
Mothers with recurrent depression and their adolescent offspring (9–17 years at baseline) were assessed in 2007 and on two further occasions up to 2011. Mothers completed questionnaires assessing depression severity, anxiety, alcohol problems and antisocial behaviour. Psychiatric disorder in offspring was assessed using the Child and Adolescent Psychiatric Assessment.
The number of co-occurring problems in mothers (0, 1 or 2+) predicted new-onset offspring disorder (odds ratio (OR) = 1.80, 95% CI 1.17–2.77, P = 0.007). Rates varied from 15.7 to 34.8% depending on the number of co-occurring clinical problems. This remained significant after controlling for maternal depression severity (OR = 1.73, 95% CI 1.03–2.89, P = 0.040).
The burden of co-occurring psychopathology among mothers with recurrent depression indexes increased risk of future onset of psychiatric disorder for offspring. This knowledge can be used in targeting preventive measures in children at high risk of psychiatric disorder.