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35 results

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  • Self-reported reasons for reducing or stopping antidepressant medications in primary care: thematic analysis of the diamond longitudinal study

  • Amy Coe, Jane Gunn, Susan Fletcher, Elizabeth Murray, Catherine Kaylor-Hughes
  • Journal:
    Primary Health Care Research & Development / Volume 24 / 2023
    Published online by Cambridge University Press:
    27 February 2023, e16
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  • Background:

    Current treatment guidelines advise that the deprescribing of antidepressants should occur around 6 months post-remission of symptoms. However, this is not routinely occurring in clinical practice, with between 30% and 50% of antidepressant users potentially continuing treatment with no clinical benefit. To support patients to deprescribe antidepressant treatment when clinically appropriate, it is important to understand what is important to patients when making the decision to reduce or cease antidepressants in a naturalistic setting.

    Aim:

    The current study aimed to describe the self-reported reasons primary care patients have for reducing or stopping their antidepressant medication.

    Methods:

    Three hundred and seven participants in the diamond longitudinal study reported taking an SSRI/SNRI over the life of the study. Of the 307, 179 reported stopping or tapering their antidepressant during computer-assisted telephone interviews and provided a reason for doing so. A collective case study approach was used to collate the reasons for stopping or tapering.

    Findings:

    Reflexive thematic analysis of patient-reported factors revealed five overarching themes; 1. Depression; 2. Medication; 3. Healthcare system; 4. Psychosocial, and; 5. Financial. These findings are used to inform suggestions for the development and implementation of antidepressant deprescribing discussions in clinical practice.

  • Do, say, learn: the functions of mothers’ speech to infants

  • Yana A. KUCHIRKO, Jacob L. SCHATZ, Katelyn K. FLETCHER, Catherine S. TAMIS-LEMONDA
  • Journal:
    Journal of Child Language / Volume 47 / Issue 1 / January 2020
    Published online by Cambridge University Press:
    22 July 2019, pp. 64-84

  • We examined the functions of mothers’ speech to infants during two tasks – book-sharing and bead-stringing – in low-income, ethnically diverse families. Mexican, Dominican, and African American mothers and their infants were video-recorded sharing wordless books and toy beads in the home when infants were aged 1;2 and 2;0. Mothers’ utterances were classified into seven categories (labels/descriptions, emotion/state language, attention directives, action directives, prohibitions, questions, and vocal elicitations) which were grouped into three broad language functions: referential language, regulatory language, and vocalization prompts. Mothers’ ethnicity, years of education, years living in the United States, and infant sex and age related to mothers’ language functions. Dominican and Mexican mothers were more likely to use regulatory language than were African American mothers, and African American mothers were more likely to use vocalization prompts than were Latina mothers. Vocalization prompts and referential language increased with mothers’ education and Latina mothers’ years living in the United States. Finally, mothers of boys used more regulatory language than did mothers of girls. Socio-cultural and developmental contexts shape the pragmatics of mothers’ language to infants.

  • Half-Earth or Whole Earth? Radical ideas for conservation, and their implications

  • Bram Büscher, Robert Fletcher, Dan Brockington, Chris Sandbrook, William M. Adams, Lisa Campbell, Catherine Corson, Wolfram Dressler, Rosaleen Duffy, Noella Gray, George Holmes, Alice Kelly, Elizabeth Lunstrum, Maano Ramutsindela, Kartik Shanker
  • Journal:
    Oryx / Volume 51 / Issue 3 / July 2017
    Published online by Cambridge University Press:
    05 December 2016, pp. 407-410
    Print publication:
    July 2017
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  • We question whether the increasingly popular, radical idea of turning half the Earth into a network of protected areas is either feasible or just. We argue that this Half-Earth plan would have widespread negative consequences for human populations and would not meet its conservation objectives. It offers no agenda for managing biodiversity within a human half of Earth. We call instead for alternative radical action that is both more effective and more equitable, focused directly on the main drivers of biodiversity loss by shifting the global economy from its current foundation in growth while simultaneously redressing inequality.

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