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Positive symptoms are a useful predictor of aggression in schizophrenia. Although a similar pattern of abnormal brain structures related to both positive symptoms and aggression has been reported, this observation has not yet been confirmed in a single sample.
To study the association between positive symptoms and aggression in schizophrenia on a neurobiological level, a prospective meta-analytic approach was employed to analyze harmonized structural neuroimaging data from 10 research centers worldwide. We analyzed brain MRI scans from 902 individuals with a primary diagnosis of schizophrenia and 952 healthy controls.
The result identified a widespread cortical thickness reduction in schizophrenia compared to their controls. Two separate meta-regression analyses revealed that a common pattern of reduced cortical gray matter thickness within the left lateral temporal lobe and right midcingulate cortex was significantly associated with both positive symptoms and aggression.
These findings suggested that positive symptoms such as formal thought disorder and auditory misperception, combined with cognitive impairments reflecting difficulties in deploying an adaptive control toward perceived threats, could escalate the likelihood of aggression in schizophrenia.
The first episode of psychosis is a critical period in the emergence of cardiometabolic risk.
We set out to explore the influence of individual and lifestyle factors on cardiometabolic outcomes in early psychosis.
This was a prospective cohort study of 293 UK adults presenting with first-episode psychosis investigating the influence of sociodemographics, lifestyle (physical activity, sedentary behaviour, nutrition, smoking, alcohol, substance use) and medication on cardiometabolic outcomes over the following 12 months.
Rates of obesity and glucose dysregulation rose from 17.8% and 12%, respectively, at baseline to 23.7% and 23.7% at 1 year. Little change was seen over time in the 76.8% tobacco smoking rate or the quarter who were sedentary for over 10 h daily. We found no association between lifestyle at baseline or type of antipsychotic medication prescribed with either baseline or 1-year cardiometabolic outcomes. Median haemoglobin A1c (HbA1c) rose by 3.3 mmol/mol in participants from Black and minority ethnic (BME) groups, with little change observed in their White counterparts. At 12 months, one-third of those with BME heritage exceeded the threshold for prediabetes (HbA1c >39 mmol/mol).
Unhealthy lifestyle choices are prevalent in early psychosis and cardiometabolic risk worsens over the next year, creating an important window for prevention. We found no evidence, however, that preventative strategies should be preferentially directed based on lifestyle habits. Further work is needed to determine whether clinical strategies should allow for differential patterns of emergence of cardiometabolic risk in people of different ethnicities.
While poor parental bonding has been linked with psychological distress, few studies have assessed bonding with mothers and fathers separately among adolescents and whether there are gender differences in the relationships between bonding and psychological distress. Additionally, low self-esteem has been shown to predict psychological distress, but low self-esteem may develop as a result of poor bonding with parental figures. We explored the relationships between (a) perceived maternal and paternal bonding factors and (b) psychological distress, and examined whether self-esteem mediated these relationships in a non-clinical sample of 337 adolescents (aged 13–17 years, M = 14.17, 50.6% female) in Canberra, Australia. Relative to males, females reported lower levels of self-esteem and higher levels of psychological distress. For females, low self-esteem and perceived maternal or paternal rejection predicted higher levels of psychological distress, whereas low self-esteem predicted psychological distress for males. Implications for future research and further considerations are discussed.
OBJECTIVES/SPECIFIC AIMS: The purpose of the present secondary data analysis was to examine the effect of moderate-severe disturbed sleep before the start of radiation therapy (RT) on subsequent RT-induced pain. METHODS/STUDY POPULATION: Analyses were performed on 676 RT-naïve breast cancer patients (mean age 58, 100% female) scheduled to receive RT from a previously completed nationwide, multicenter, phase II randomized controlled trial examining the efficacy of oral curcumin on radiation dermatitis severity. The trial was conducted at 21 community oncology practices throughout the US affiliated with the University of Rochester Cancer Center NCI’s Community Oncology Research Program (URCC NCORP) Research Base. Sleep disturbance was assessed using a single item question from the modified MD Anderson Symptom Inventory (SI) on a 0–10 scale, with higher scores indicating greater sleep disturbance. Total subjective pain as well as the subdomains of pain (sensory, affective, and perceived) were assessed by the short-form McGill Pain Questionnaire. Pain at treatment site (pain-Tx) was also assessed using a single item question from the SI. These assessments were included for pre-RT (baseline) and post-RT. For the present analyses, patients were dichotomized into 2 groups: those who had moderate-severe disturbed sleep at baseline (score≥4 on the SI; n=101) Versus those who had mild or no disturbed sleep (control group; score=0–3 on the SI; n=575). RESULTS/ANTICIPATED RESULTS: Prior to the start of RT, breast cancer patients with moderate-severe disturbed sleep at baseline were younger, less likely to have had lumpectomy or partial mastectomy while more likely to have had total mastectomy and chemotherapy, more likely to be on sleep, anti-anxiety/depression, and prescription pain medications, and more likely to suffer from depression or anxiety disorder than the control group (all p’s≤0.02). Spearman rank correlations showed that changes in sleep disturbance from baseline to post-RT were significantly correlated with concurrent changes in total pain (r=0.38; p<0.001), sensory pain (r=0.35; p<0.001), affective pain (r=0.21; p<0.001), perceived pain intensity (r=0.37; p<0.001), and pain-Tx (r=0.35; p<0.001). In total, 92% of patients with moderate-severe disturbed sleep at baseline reported post-RT total pain compared with 79% of patients in the control group (p=0.006). Generalized linear estimating equations, after controlling for baseline pain and other covariates (baseline fatigue and distress, age, sleep medications, anti-anxiety/depression medications, prescription pain medications, and depression or anxiety disorder), showed that patients with moderate-severe disturbed sleep at baseline had significantly higher mean values of post-RT total pain (by 39%; p=0.033), post-RT sensory pain (by 41%; p=0.046), and post-RT affective pain (by 55%; p=0.035) than the control group. Perceived pain intensity (p=0.066) and pain-Tx (p=0.086) at post-RT were not significantly different between the 2 groups. DISCUSSION/SIGNIFICANCE OF IMPACT: These findings suggest that moderate-severe disturbed sleep prior to RT is an important predictor for worsening of pain at post-RT in breast cancer patients. There could be several plausible reasons for this. Sleep disturbance, such as sleep loss and sleep continuity disturbance, could result in impaired sleep related recovery and repair of tissue damage associated with cancer and its treatment; thus, resulting in the amplification of pain. Sleep disturbance may also reduce pain tolerance threshold through increased sensitization of the central nervous system. In addition, pain and sleep disturbance may share common neuroimmunological pathways. Sleep disturbance may modulate inflammation, which in turn may contribute to increased pain. Further research is needed to confirm these findings and whether interventions targeting sleep disturbance in early phase could be potential alternate approaches to reduce pain after RT.
Variable OH/IR stars are Asymptotic Giant Branch (AGB) stars with an optically thick circumstellar envelope that emit strong OH 1612 MHz emission. They are commonly observed throughout the Galaxy but also in the LMC and SMC. Hence, the precise inference of the distances of these stars will ultimately result in better constraints on their mass range in different metallicity environments. Through a multi-year long-term monitoring program at the Nancay Radio telescope (NRT) and a complementary high-sensitivity mapping campaign at the eMERLIN and JVLA to measure precisely the angular diameter of the envelopes, we have been re-exploring distance determination through the phase-lag method for a sample of stars, in order to refine the poorly-constrained distances of some and infer the currently unknown distances of others. We present here an update of this project.
Timing of weed emergence and seed persistence in the soil influence the ability to implement timely and effective control practices. Emergence patterns and seed persistence of kochia populations were monitored in 2010 and 2011 at sites in Kansas, Colorado, Wyoming, Nebraska, and South Dakota. Weekly observations of emergence were initiated in March and continued until no new emergence occurred. Seed was harvested from each site, placed into 100-seed mesh packets, and buried at depths of 0, 2.5, and 10 cm in fall of 2010 and 2011. Packets were exhumed at 6-mo intervals over 2 yr. Viability of exhumed seeds was evaluated. Nonlinear mixed-effects Weibull models were fit to cumulative emergence (%) across growing degree days (GDD) and to viable seed (%) across burial time to describe their fixed and random effects across site-years. Final emergence densities varied among site-years and ranged from as few as 4 to almost 380,000 seedlings m−2. Across 11 site-years in Kansas, cumulative GDD needed for 10% emergence were 168, while across 6 site-years in Wyoming and Nebraska, only 90 GDD were needed; on the calendar, this date shifted from early to late March. The majority (>95%) of kochia seed did not persist for more than 2 yr. Remaining seed viability was generally >80% when seeds were exhumed within 6 mo after burial in March, and declined to <5% by October of the first year after burial. Burial did not appear to increase or decrease seed viability over time but placed seed in a position from which seedling emergence would not be possible. High seedling emergence that occurs very early in the spring emphasizes the need for fall or early spring PRE weed control such as tillage, herbicides, and cover crops, while continued emergence into midsummer emphasizes the need for extended periods of kochia management.
Objective: Multiple system atrophy (MSA) is an incurable neurodegenerative illness in which progressive symptoms, including stridor and acute laryngeal obstruction, occur. Advanced care planning and palliative care discussions in people living with MSA are not well defined. The aim of the present study is to evaluate advanced care planning and current practices in palliative care in MSA to identify opportunities for improving quality of care. Methods: The study is a retrospective chart review assessing the focus and timing of palliative care discussions in people living with MSA. Some 22 charts were reviewed. Results: A total of 22 patients were included. The most common symptoms were parkinsonism, orthostatic hypotension, GI/GU dysfunction, ataxia and gait impairment. Six patients had stridor. Of the palliative care discussions that took place, the most common topics were diagnosis, symptoms or symptom management, and prognosis. In the majority of patients who died and who had a do-not-attempt-resuscitation order, discussions surrounding resuscitation and goals of care took place only hours before death. Conclusions: There is no standard approach to advanced care planning and palliative care discussions in people living with MSA. We propose a framework to guide advanced care planning and palliative care discussions in MSA.
Local health departments (LHDs) have little guidance for operationalizing community resilience (CR). We explored how community coalitions responded to 4 CR levers (education, engagement, partnerships, and community self-sufficiency) during the first planning year of the Los Angeles County Community Disaster Resilience (LACCDR) Project.
Sixteen communities were selected and randomly assigned to the experimental CR group or the control preparedness group. Eight CR coalitions met monthly to plan CR-building activities or to receive CR training from a public health nurse. Trained observers documented the coalitions’ understanding and application of CR at each meeting. Qualitative content analysis was used to analyze structured observation reports around the 4 levers.
Analysis of 41 reports suggested that coalitions underwent a process of learning about and applying CR concepts in the planning year. Groups resonated with ideas of education, community self-sufficiency, and engagement, but increasing partnerships was challenging.
LHDs can support coalitions by anticipating the time necessary to understand CR and by facilitating engagement. Understanding the issues that emerge in the early phases of planning and implementing CR-building activities is critical. LHDs can use the experience of the LACCDR Project’s planning year as a guide to navigate challenges and issues that emerge as they operationalize the CR model. (Disaster Med Public Health Preparedness. 2016;10:812–821)
Auditory processing and spoken word recognition difficulties have been observed in Specific Language Impairment (SLI), raising the possibility that auditory perceptual deficits disrupt word recognition and, in turn, phonological processing and oral language. In this study, fifty-seven kindergarten children with SLI and fifty-three language-typical age-matched controls were assessed with a speech-gating task to measure spoken word recognition, psychophysical tasks to measure auditory Frequency Modulation (FM) detection and Frequency Discrimination (FD), and standardized psychometric tests of phonological processing and oral language. As a group, children with SLI took significantly longer than language-typical controls to recognize words with high neighborhood density, perhaps reflecting subpar phonological representations. FM, but not FD, was significantly worse in SLI. However, while both poorer speech-gating performance and poorer auditory thresholds (FM) were evident in SLI, spoken word recognition did not mediate any relation between auditory perception and either phonological processing or oral language.
A thorough understanding of adolescent drinking and delinquent behaviour is required in order to implement early prevention and intervention programs in schools. Broadly based on the common cause model of adolescent deviance, this study investigated and compared, across genders, the prevalence and inter-relationships of various indicators of adolescent drinking and delinquency. Participants were 312 secondary school students (aged 13–17, 57.7% male) in Canberra, Australia, who completed an anonymous survey comprising the Alcohol Use Disorders Identification Test and the Australian Self-Reported Delinquency Scale — Revised. We found very few gender differences in drinking and delinquency patterns, and noted medium-to-strong associations among various dimensions of adolescent drinking and delinquent activities. Resulting implications for school prevention programs are considered.
Reports of kochia control failure with glyphosate in western Kansas increased dramatically in the years following confirmed presence of glyphosate-resistant (GR) populations in 2007. In this study, progeny from 8 of 16 geographically dispersed kochia populations in western Kansas (seed collected in 2010) were confirmed to be resistant to glyphosate by conducting whole-plant dose-response (in greenhouse and/or outdoor environments) and shikimate-accumulation assays. Additionally, the relationship between 5-enolpyruvylshikimate-3-phosphate synthase (EPSPS) gene copy number and glyphosate resistance levels was investigated. A known glyphosate-susceptible (GS) kochia population from Ellis County, Kansas was used for comparison in all studies. Based on the herbicide rate that caused 50% reduction in biomass compared to untreated control (GR50) values, the 8 GR kochia populations were 4 to 11 times more resistant to glyphosate compared to the GS population. The GR50 values of kochia populations were 1.58 to 1.85 times higher under an outdoor environment compared to when grown in the greenhouse. Glyphosate-treated leaf discs of the GS kochia plants accumulated consistently higher amounts of shikimate than those of the GR plants. Additionally, the GR plants with higher levels of resistance to glyphosate had higher EPSPS : acetolactate synthase (ALS) relative gene copy number compared to those with low levels of resistance.
Increasing ethnic and cultural diversity worldwide and especially in Australia requires that psychologists and counsellors cultivate the knowhow to interact and work effectively with clients and stakeholders in cross-cultural contexts. This study aimed to identify and compare themes regarding challenging intercultural social scenarios experienced by supervising, practising and intern psychologists. Transcripts from five focus groups were open-coded on four occasions and the final themes compared with the EXCELL (Excellence in Cultural Experiential Learning and Leadership) program's six key sociocultural competencies (Mak, Westwood, Barker, & Ishiyama, 1998). We found that many challenges reported by psychologists (regardless of their qualifications) were related to difficulties — for psychologists and clients — in executing one or more of key sociocultural competencies: seeking help or information, participating in a group, making social contact, giving feedback, refusing a request, and expressing disagreement. We also identified barriers to cultural competence in therapeutic relationships, including cultural identity issues, needing to address difficulties in intimate relationships, cultural variation in values/beliefs/social norms, mismatched expectations, psychologists’ perceived deficit in intercultural training, and challenges in self-reflection. Based on our findings, we propose a model of culturally competent counselling practice and discuss implications for counsellor and psychologist training, and for future research.
X-ray diffraction (XRD) was used to determine the temperature at which the transformation of Ce2O(CO3)2·H2O to ceria (CeO2) occurs under both a flow of nitrogen and air as a function of temperature. The Ce2O(CO3)2·H2O synthesised from Ce(NO3)3·6H2O and urea was further investigated using thermal gravimetric analysis (TGA), scanning electron microscopy (SEM), and transmission electron microscopy (TEM). XRD results indicate that, under a flow of nitrogen, CeO2 is formed at temperatures greater than 500 °C and that this occurs via an as yet unidentified intermediate phase, which is present between 430 and 540 °C. Results obtained by the XRD correspond to those obtained using TGA, which show weight losses commencing at 430 and at 465 °C. No further weight loss occurs above 540 °C, because of the formation of CeO2 as the stable product. The crystallite size was also determined and observed to increase with increasing temperature. Under a flow of air the transformation occurred at a lower temperature, as CeO2 was formed at 250 °C. SEM and TEM reveal the particles have a rod-shaped morphology which is retained after calcination. These results may be used to optimise synthesis methods to minimise crystallite size growth and reduce sintering that is undesirable in many applications, particularly catalysis.