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Incorporating consumer perspectives into mental health services design is important in working to deliver recovery-oriented care. One of the challenges faced in mental health rehabilitation services is limited consumer engagement with the available support. Listening to consumers’ expectations of mental health services, and what they hope to achieve, provides an opportunity to examine the alignment between existing services and the priorities and preferences of the people who use them. We explored consumer understandings and expectations of three recovery-oriented community-based residential mental-health rehabilitation units using semi-structured interviews; two of these units were trialling a staffing model integrating peer support with clinical care.
Twenty-four consumers completed semi-structured interviews with an independent interviewer during the first 6 weeks of their stay at the rehabilitation unit. Most participants had a primary diagnosis of schizophrenia or a related psychotic disorder (87%). A pragmatic approach to grounded theory guided the analysis, facilitating identification of content and themes, and the development of an overarching conceptual map.
The rehabilitation units were considered to provide a transformational space and a transitional place. The most common reason given for engagement was housing insecurity or homelessness rather than the opportunity for rehabilitation engagement. Differences in expectations did not emerge between consumers entering the clinical and integrated staffing model sites.
Consumers understand the function of the rehabilitation service they are entering. However, receiving rehabilitation support may not be the key driver of their attendance. This finding has implications for promoting consumer engagement with rehabilitation services. The absence of differences between the integrated and clinical staffing models may reflect the novelty of the rehabilitation context. The study highlights the need for staff to find better ways to increase consumer awareness of the potential relevance of evidence-based rehabilitation support to facilitating their recovery.
Recent studies point to overlap between neuropsychiatric disorders in symptomatology and genetic aetiology.
To systematically investigate genomics overlap between childhood and adult attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and major depressive disorder (MDD).
Analysis of whole-genome blood gene expression and genetic risk scores of 318 individuals. Participants included individuals affected with adult ADHD (n = 93), childhood ADHD (n = 17), MDD (n = 63), ASD (n = 51), childhood dual diagnosis of ADHD–ASD (n = 16) and healthy controls (n = 78).
Weighted gene co-expression analysis results reveal disorder-specific signatures for childhood ADHD and MDD, and also highlight two immune-related gene co-expression modules correlating inversely with MDD and adult ADHD disease status. We find no significant relationship between polygenic risk scores and gene expression signatures.
Our results reveal disorder overlap and specificity at the genetic and gene expression level. They suggest new pathways contributing to distinct pathophysiology in psychiatric disorders and shed light on potential shared genomic risk factors.
In 1969, Robert E. Gregg collected five species of ants (Hymenoptera: Formicidae) in three Subarctic localities near the town of Churchill, Manitoba, Canada, which he documented in a 1972 publication in The Canadian Entomologist. To determine whether there have been any additions to the local fauna – as might be predicted to occur in response to a warming climate and increased traffic to the Port of Churchill in the intervening 40 years – we re-collected ants from the same localities in 2012. We identified the ants we collected from Gregg’s sampling sites using both traditional morphological preparations and DNA barcoding. In addition, we examined specimens from Gregg’s initial collection that are accessioned at the Field Museum of Natural History (Chicago, Illinois, United States of America). Using this integrative approach we report seven species present at the same sites Gregg sampled 40 years earlier. We conclude that the apparent increase is likely not due to any arrivals from more southerly distributed ants, but to the increased resolution provided by DNA barcodes to resident species complexes with a complicated history. We provide a brief synopsis of these results and their taxonomic context.
This study assessed the prescription of potentially nephrotoxic non-steroidal anti-inflammatory drugs (NSAIDs) to patients with chronic kidney disease (CKD) in general practice.
CKD poses a considerable disease burden in the UK. Guidelines state that caution should be exercised when prescribing NSAIDs to CKD patients, due to increased risk of rapid kidney disease progression.
We reviewed the medical records of 1427 patients with CKD Stages 3–5 in seven general practices in West Yorkshire.
A total of 792 (55.5%) were prescribed NSAIDs; 128 (9%) of these were prescribed NSAIDs excluding low-dose aspirin. Twenty-three (20.2%) patients who were prescribed NSAIDs had no record of CKD monitoring in the preceding year.
Prescription of NSAIDs is likely to be contributing to unnecessary renal impairment.
The ultrastructural study of rare cells within their niche in situ is very difficult. We have developed a method for locating individual transplanted cells and simultaneously identifying and analyzing the molecules and cellular phenotypes surrounding them in situ using transmission electron microscopy. This innovative method involves triple immunogold labeling combined with serial ultrathin sectioning. We demonstrate the validity of this approach by examining the niche of individual transplanted cells from a population highly enriched for hemopoietic stem cells and the ultrastructural expression of two key stem cell regulatory molecules, hyaluronic acid and osteopontin. In addition, we describe the phenotypes of the surrounding cells.
In recent years, it has become common for academic writers to use ‘the occult’ as an analytical category to which are assigned various types of mystical belief and activity that are quite widespread in Africa, including those often described as ‘magic’ and ‘witchcraft’. It is notable that all these concepts generally go undefined. The present article argues that much of the current academic vocabulary used to describe and analyse the invisible world that many Africans believe to exist is tainted by an intellectual history associated with colonialism. Instead, we propose that much African thought and action related to the invisible world should be considered in terms of religion, with the latter being defined contextually as a belief in the existence of an invisible world, distinct but not separate from the visible one, that is home to spiritual beings with effective powers over the material world.
The Nigerian police discovered dozens of corpses at a shrine in Anambra State, in southeastern Nigeria, in 2004. There were suggestions in the many newspapers covering the story that these were evidence of what Nigerians call ‘ritual murders’. In fact, the corpses almost certainly were of people who had died elsewhere and been removed to the shrine only subsequently. However, the revelation that senior political figures had attended the Okija shrine and sworn oaths there drew attention to an informal politics in which traditional shrines credited with powers of life and death may play an important role, of interest even to national politicians. Discerning why this is so entails considering the long-term effects of the colonial policy of Indirect Rule and the subsequent development of a clandestine political system in which local religious institutions sometimes play an important role.
The monarchies and other polities of precolonial Madagascar exerted a strong influence on each other. For this reason, in recent years it has become more interesting to trace their inter-relationship than to emphasize their autonomy. The Betsimisaraka kingdom, which flourished on Madagascar's east coast in the early eighteenth century, has generally been regarded as a polity standing rather outside the mainstream of state formation in Madagascar, not least because of the identity of its founder, the son of an English pirate. Research in European and South African archives demonstrates the close connection between the Betsimisaraka kingdom and the Sakalava kingdom of Boina.
Religious modes of thinking about the world are widespread in Africa, and have a pervasive influence on politics in the broadest sense. We have published elsewhere a theoretical model as to how the relationship between politics and religion may be understood, with potential benefits for observers not just of Africa, but also of other parts of the world where new combinations of religion and politics are emerging. Application of this theoretical model requires researchers to rethink some familiar categories of social science.
While many recent advances have been made in the breeding of giant pandas ex situ, historically this species has never reproduced well in captivity. Sexual incompatibility, health problems, low fecundity and a juvenile mortality rate in excess of 70% have contributed to low reproductive success (O'Brien & Knight, 1987; O'Brien et al., 1994; Peng et al., 2001a, b). Wild- and captive-born giant pandas, particularly those captured at a young age, traditionally had difficulty producing offspring in captivity upon becoming adults (Lu & Kemf, 2001). As a result, the ex-situ giant panda population has not been self-sustaining and, until recently, its growth has relied on introducing animals captured from nature. In some cases, this included individuals that appeared ill (rescues) or cubs that were believed to be neglected or abandoned by their mothers. Later field studies, however, revealed that females often leave cubs alone for four to eight hours while foraging, and in one documented case for 52 hours (Lu et al., 1994). Recently, China has placed a general moratorium on capturing wild giant pandas for captive breeding (Lu & Kemf, 2001), a move that forces the breeding community to develop a self-sustaining population.
The goal, however, is not only ensuring demographic self-sustainability but also the maintenance of genetic diversity. The deleterious effects of inbreeding are well recognised (O'Brien, 1994a; Frankham, 1995; Hedrick & Kalinowski, 2001; Frankham et al., 2002).