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Maternal mental health during pregnancy and postpartum predicts later emotional and behavioural problems in children. Even though most perinatal mental health problems begin before pregnancy, the consequences of preconception maternal mental health for children's early emotional development have not been prospectively studied.
We used data from two prospective Australian intergenerational cohorts, with 756 women assessed repeatedly for mental health problems before pregnancy between age 13 and 29 years, and during pregnancy and at 1 year postpartum for 1231 subsequent pregnancies. Offspring infant emotional reactivity, an early indicator of differential sensitivity denoting increased risk of emotional problems under adversity, was assessed at 1 year postpartum.
Thirty-seven percent of infants born to mothers with persistent preconception mental health problems were categorised as high in emotional reactivity, compared to 23% born to mothers without preconception history (adjusted OR 2.1, 95% CI 1.4–3.1). Ante- and postnatal maternal depressive symptoms were similarly associated with infant emotional reactivity, but these perinatal associations reduced somewhat after adjustment for prior exposure. Causal mediation analysis further showed that 88% of the preconception risk was a direct effect, not mediated by perinatal exposure.
Maternal preconception mental health problems predict infant emotional reactivity, independently of maternal perinatal mental health; while associations between perinatal depressive symptoms and infant reactivity are partially explained by prior exposure. Findings suggest that processes shaping early vulnerability for later mental disorders arise well before conception. There is an emerging case for expanding developmental theories and trialling preventive interventions in the years before pregnancy.
Potentially modifiable risk factors for developing dementia have been identified. However, risk factors for increased mortality in patients with diagnosed dementia are not well understood. Identifying factors that influence prognosis would help clinicians plan care and address unmet needs.
To investigate diagnosed depression and sociodemographic factors as predictors of mortality in patients with dementia in UK secondary clinical care services.
We conducted a cohort study of patients with a dementia diagnosis in an electronic health records database in a UK National Health Service mental health trust.
In 3374 patients with 10 856 person-years of follow-up, comorbid depression was not associated with mortality (adjusted hazard ratio 0.94; 95% CI 0.71–1.24). Single patients had higher mortality than those who were married (adjusted hazard ratio 1.25; 95% CI 1.03–1.50). Patients of Asian ethnicity had lower mortality rates than White British patients (adjusted hazard ratio 0.50; 95% CI 0.34–0.73).
Clinically diagnosed depression does not increase mortality in patients with dementia. Patients who are single are a potential high-mortality risk group. Lower mortality rates in Asian patients with dementia that have been reported in the USA also apply in the UK.
UK Biobank is a well-characterised cohort of over 500 000 participants that offers unique opportunities to investigate multiple diseases and risk factors.
An online mental health questionnaire completed by UK Biobank participants was expected to expand the potential for research into mental disorders.
An expert working group designed the questionnaire, using established measures where possible, and consulting with a patient group regarding acceptability. Case definitions were defined using operational criteria for lifetime depression, mania, anxiety disorder, psychotic-like experiences and self-harm, as well as current post-traumatic stress and alcohol use disorders.
157 366 completed online questionnaires were available by August 2017. Comparison of self-reported diagnosed mental disorder with a contemporary study shows a similar prevalence, despite respondents being of higher average socioeconomic status than the general population across a range of indicators. Thirty-five per cent (55 750) of participants had at least one defined syndrome, of which lifetime depression was the most common at 24% (37 434). There was extensive comorbidity among the syndromes. Mental disorders were associated with high neuroticism score, adverse life events and long-term illness; addiction and bipolar affective disorder in particular were associated with measures of deprivation.
The questionnaire represents a very large mental health survey in itself, and the results presented here show high face validity, although caution is needed owing to selection bias. Built into UK Biobank, these data intersect with other health data to offer unparalleled potential for crosscutting biomedical research involving mental health.
Declaration of interest
G.B. received grants from the National Institute for Health Research during the study; and support from Illumina Ltd. and the European Commission outside the submitted work. B.C. received grants from the Scottish Executive Chief Scientist Office and from The Dr Mortimer and Theresa Sackler Foundation during the study. C.S. received grants from the Medical Research Council and Wellcome Trust during the study, and is the Chief Scientist for UK Biobank. M.H. received grants from the Innovative Medicines Initiative via the RADAR-CNS programme and personal fees as an expert witness outside the submitted work.
Several parameters of the solar rotation show variations which appear to relate to the phase of the solar activity cycle. The latitude gradient of the differential rotation, as seen in the coefficients of the sin2 and sin4 terms in the latitude expansion, shows marked variations with the cycle. One of these variations may be described as a one-cycle-per-hemisphere torsional oscillation with a period of 11 years, where the high latitudes rotate faster at solar activity maximum and slower at minimum, and the low latitudes rotate faster at solar activity minimum and slower at maximum. Another variation is a periodic oscillation of the fractional difference in the low-latitude rotation between north and south hemispheres. The possibility of a variation in the absolute rotational velocity of the sun in phase with the solar cycle remains an open question. The two-cycle-per-hemisphere torsional waves in the solar rotation also represent an aspect of the rotation which varies with the cycle. We show that the amplitude of the fast flowing zone rises a year before the rise to activity maximum. The fast zone seems to be physically the more significant of the two zones.
Electronic patient records were used to investigate the level of engagement and treatment that patients with very late-onset schizophrenia-like psychosis (VLOSLP) had with mental health services.
Of 131 patients assessed and diagnosed, 63 (48%) were taking antipsychotic treatment at 3 months, 46 (35%) at 6 months and 36 (27%) at 12 months. At discharge from mental health services, 54% of patients had failed to engage with services or became lost to follow-up, 18% had engaged with services but were not taking antipsychotic medication and only 28% were taking treatment.
Results showed that less than half of the patients with VLOSLP were commenced on antipsychotic treatment and less than a third remained on treatment at 1 year or at point of discharge. This highlights the need for services to consider being more assertive in taking potentially effective treatment to this patient group.
In this paper we describe a new observing system which is currently nearing completation at the Mount Wilson Observatory. This system has been designed to obtain daily measurements of solar photospheric and subphotospheric rotational velocities from the frequency splitting of non-radial solar p-mode oscillations of moderate to high degree (i.e. l > 150). The completed system will combine a 244 x 248 pixel CID camera with a high-speed floating point array processor, a 32-bit minicomputer, and a large-capacity disc storage system. We are integrating these components into the spectrograph of the 60-foot solar tower telescope at Mount Wilson in order to provide a facility which will be dedicated to the acquisition of oscillation data.
The use of benzodiazepines has been advised against in older people, but
prevalence rates remain high.
To review the evidence for interventions aimed at reducing benzodiazepine
use in older people.
We conducted a systematic review, assessment of risk of bias and
meta-analyses of randomised controlled trials of benzodiazepine
withdrawal and prescribing interventions.
Ten withdrawal and eight prescribing studies met the inclusion criteria.
At post-intervention, significantly higher odds of not using
benzodiazepines were found with supervised withdrawal with psychotherapy
(odds ratio (OR) = 5.06, 95% CI 2.68–9.57, P<0.00001)
and withdrawal with prescribing interventions (OR = 1.43, 95% CI
1.02–2.02, P=0.04) in comparison with the control
interventions treatment as usual (TAU), education placebo, withdrawal
with or without drug placebo, or psychotherapy alone. Significantly
higher odds of not using benzodiazepines were also found for multifaceted
prescribing interventions (OR = 1.37, 95% CI 1.10–1.72,
P = 0.006) in comparison with control interventions
(TAU and prescribing placebo).
Supervised benzodiazepine withdrawal augmented with psychotherapy should
be considered in older people, although pragmatic reasons may necessitate
consideration of other strategies such as medication review.
Two thiophene-based semiconductors, a vapor-deposited small molecule and an amorphous polymer, as well as pentacene for comparison, show potential in enhancing the thermoelectric properties of tellurium (Te) nanowires. For vapor-deposited films, Te nanostructures form directly on glass substrates or organic semiconductor films. The resulting Te power factor (S2σ) was enhanced from 36 to 45 W/mK2 (56 for pentacene) because the bilayer provides an enhancement in Seebeck (S) without compromising conductivity (σ). For solution deposited polymer blends, we obtained power factors from a Te nanowire network that alone would not have sufficient connectivity (up to 0.1 µW/mK2). While the organics are unoptimized, they are prototypical materials for further development.