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Humans have engineered their environments throughout the Holocene, especially in the construction of hydraulic infrastructure. In many regions, however, this infrastructure is difficult to date, including the vestiges of water-management systems in the Andean highlands. Focusing on silt reservoirs in the upper Ica drainage, Peru, the authors use cores and radiocarbon dates to demonstrate the pre-Hispanic construction of walls to enhance and expand wetlands for camelid pasture. Interventions dated to the Inca period (AD 1400–1532) indicate an intensification of investment in hydraulic infrastructure to expand production capacity in support of the state. The results are discussed in the context of the hydraulic strategies of other states and empires.
Child welfare and juvenile justice placed youths show high levels of psychosocial burden and high rates of mental disorders. It remains unclear how mental disorders develop into adulthood in these populations. The aim was to present the rates of mental disorders in adolescence and adulthood in child welfare and juvenile justice samples and to examine their mental health trajectories from adolescence into adulthood.
Seventy adolescents in shared residential care, placed by child welfare (n = 52, mean age = 15 years) or juvenile justice (n = 18, mean age = 17 years) authorities, were followed up into adulthood (child welfare: mean age = 25 years; juvenile justice: mean age = 27 years). Mental disorders were assessed based on the International Classification of Diseases 10th Revision diagnoses at baseline and at follow-up. Epidemiological information on mental disorders was presented for each group. Bivariate correlations and structural equation modeling for the relationship of mental disorders were performed.
In the total sample, prevalence rates of 73% and 86% for any mental disorder were found in adolescence (child welfare: 70%; juvenile justice: 83%) and adulthood (child welfare: 83%; juvenile justice: 94%) respectively. General psychopathology was found to be stable from adolescence into adulthood in both samples.
Our findings showed high prevalence rates and a high stability of general psychopathology into adulthood among child welfare and juvenile justice adolescents in Swiss residential care. Therefore, continuity of mental health care and well-prepared transitions into adulthood for such individuals is highly warranted.
Clomiphene (clomifene) citrate (CC) and follicle-stimulating hormone (FSH) have traditionally been considered the two main modalities used for ovarian stimulation (OS). However, many adjuncts have been used to maximize the convenience and effectiveness of these two agents, often specifically targeted to subsets of women undergoing stimulation. Most of these adjuncts are not officially approved for these indications. Therefore, educators and practitioners must take it upon themselves to assess the evidence supporting their use, and make treatment recommendations and decisions accordingly. We have outlined in an editorial in Fertility and Sterility a process to aid in this endeavor . Decisions are based not only on randomized clinical trials (RCT), but also on other basic science and clinical evidence supporting their use.
The mental health impact of the initial years of military service is an under-researched area. This study is the first to explore mental health trajectories and associated predictors in military members across the first 3–4 years of their career to provide evidence to inform early interventions.
This prospective cohort study surveyed Australian Defence personnel (n = 5329) at four time-points across their early military career. Core outcomes were psychological distress (K10+) and posttraumatic stress symptoms [four-item PTSD Checklist (PCL-4)] with intra-individual, organizational and event-related trajectory predictors. Latent class growth analyses (LCGAs) identified subgroups within the sample that followed similar longitudinal trajectories for these outcomes, while conditional LCGAs examined the variables that influenced patterns of mental health.
Three clear trajectories emerged for psychological distress: resilient (84.0%), worsening (9.6%) and recovery (6.5%). Four trajectories emerged for post-traumatic stress, including resilient (82.5%), recovery (9.6%), worsening (5.8%) and chronic subthreshold (2.3%) trajectories. Across both outcomes, prior trauma exposure alongside modifiable factors, such as maladaptive coping styles, and increased anger and sleep difficulties were associated with the worsening and chronic subthreshold trajectories, whilst members in the resilient trajectories were more likely to be male, report increased social support from family/friends and Australian Defence Force (ADF) sources, and use adaptive coping styles.
The emergence of symptoms of mental health problems occurs early in the military lifecycle for a significant proportion of individuals. Modifiable factors associated with wellbeing identified in this study are ideal targets for intervention, and should be embedded and consolidated throughout the military career.
Refugees typically spend years in a state of protracted displacement prior to permanent resettlement. Little is known about how various prior displacement contexts influence long-term mental health in resettled refugees. In this study, we aimed to determine whether having lived in refugee camps v. community settings prior to resettlement impacted the course of refugees' psychological distress over the 4 years following arrival in Australia.
Participants were 1887 refugees who had taken part in the Building a New Life in Australia study, which comprised of five annual face-to-face or telephone surveys from the year of first arrival in Australia.
Latent growth curve modelling revealed that refugees who had lived in camps showed greater initial psychological distress (as indexed by the K6) and faster decreases in psychological distress in the 4 years after resettling in Australia, compared to those who had lived in community settings. Investigation of refugee camp characteristics revealed that poorer access to services in camps was associated with greater initial distress after resettlement, and greater ability to meet one's basic needs in camps was associated with faster decreases in psychological distress over time.
These findings highlight the importance of the displacement context in influencing the course of post-resettlement mental health. Increasing available services and meeting basic needs in the displacement environment may promote better mental health outcomes in resettled refugees.
Effective nutrition policies require timely, accurate individual dietary consumption data; collection of such information has been hampered by cost and complexity of dietary surveys and lag in producing results. The objective of this work was to assess accuracy and cost-effectiveness of a streamlined, tablet-based dietary data collection platform for 24-hour individual dietary recalls (24HR) administered using INDDEX24 platform v. a pen-and-paper interview(PAPI) questionnaire, with weighed food record (WFR) as a benchmark. This cross-sectional comparative study included women 18–49 years old from rural Burkina Faso (n 116 INDDEX24; n 115 PAPI). A WFR was conducted; the following day, a 24HR was administered by different interviewers. Food consumption data were converted into nutrient intakes. Validity of 24HR estimates of nutrient and food group consumption was based on comparison with WFR using equivalence tests (group level) and percentages of participants within ranges of percentage error (individual level). Both modalities performed comparably estimating consumption of macro- and micronutrients, food groups and quantities (modalities’ divergence from WFR not significantly different). Accuracy of both modalities was acceptable (equivalence to WFR significant at P < 0·05) at group level for macronutrients, less so for micronutrients and individual-level consumption (percentage within ±20 % for WFR, 17–45 % for macronutrients, 5–17 % for micronutrients). INDDEX24 was more cost-effective than PAPI based on superior accuracy of a composite nutrient intake measure (but not gram amount or item count) due to lower time and personnel costs. INDDEX24 for 24HR dietary surveys linked to dietary reference data shows comparable accuracy to PAPI at lower cost.
There is mixed evidence on the association between headache and attention-deficit/hyperactivity disorder (ADHD), as well as headache and ADHD medications. This systematic review and meta-analysis investigated the co-occurrence of headache in children with ADHD, and the effects of ADHD medications on headache. Embase, Medline and PsycInfo were searched for population-based and clinical studies comparing the prevalence of headache in ADHD and controls through January 26, 2021. In addition, we updated the search of a previous systematic review and network meta-analysis of double-blind randomized controlled trials (RCTs) on ADHD medications on June 16, 2020. Trials of amphetamines, atomoxetine, bupropion, clonidine, guanfacine, methylphenidate, and modafinil with a placebo arm and reporting data on headache as an adverse event, were included. Thirteen epidemiological studies and 58 clinical trials were eligible for inclusion. In epidemiological studies, a significant association between headache and ADHD was found [odds ratio (OR) = 2.01, 95% confidence interval (CI) = 1.63–2.46], which remained significant when limited to studies reporting ORs adjusted for possible confounders. The pooled prevalence of headaches in children with ADHD was 26.6%. In RCTs, three ADHD medications were associated with increased headache during treatment periods, compared to placebo: atomoxetine (OR = 1.29, 95% CI = 1.06–1.56), guanfacine (OR = 1.43, 95% CI = 1.12–1.82), and methylphenidate (OR = 1.33, 95% CI = 1.09–1.63). The summarized evidence suggests that headache is common in children with ADHD, both as part of the clinical presentation as such and as a side effect of some standard medications. Monitoring and clinical management strategies of headache in ADHD, in general, and during pharmacological treatment are recommended.
Arumberia is an enigmatic sedimentary surface texture that consists of parallel, sub-parallel or radiating ridges and grooves, most commonly reported from upper Neoproterozoic – lower Palaeozoic strata. It has variably been interpreted as the impression of a small metazoan, a ‘vendobiont’, a physical sedimentary structure formed on a substrate with or without a microbial mat covering, or a non-actualistic microbial community. In this paper we contribute new insights into the origin of Arumberia, resulting from the discovery of the largest contiguous bedding plane occurrence of the texture reported to date: a 300 m2 surface in the lower Cambrian Port Lazo Formation of Brittany, NW France. We compare the characteristic features of Arumberia at this locality with 38 other global records, revealing four defining characteristics: (1) the three-dimensional (3D) morphology of exposed Arumberia lines (either positive relief ‘ridges’ or negative relief ‘grooves’) records fully preserved cords within clay laminae; (2) lines may transition laterally into reticulated patterns; (3) characteristic parallel and sub-parallel Arumberia lines can become modified by desiccation on emergent substrates prior to interment; and (4) Arumberia are streamlined with palaeoflow in successions showing evidence of unidirectional currents, but are organized parallel to ripple crests where strata were sculpted by oscillatory flows. These characteristics indicate that Arumberia records a 3D entity, distinct in material properties from its host sediment, which occurred in very shallow water settings where it was prone to passive reorganization in moving water, and desiccation when water drained. A literature survey of all known Arumberia occurrences reveals that the most reliable examples of the form are stratigraphically restricted to a 40 Ma interval straddling the Ediacaran–Cambrian boundary (560–520 Ma). Together these characteristics suggest that Arumberia records the remains of extinct, sessile filamentous organisms (microbial or algal?) that occupied very shallow water and emergent environments across the globe at the dawn of the Phanerozoic Eon.
The goals of this study are to analyse the impacts of 1.5 and 2.0°C scenarios on UK winter wheat using a combination of Global Climate Models (GCMs), crop models, planting dates and cultivars; to evaluate the impact of increased air temperature on winter wheat phenology and potential yield; to quantify the underlying uncertainties due to the multiple sources of variability introduced by climate scenarios, crop models and agronomic management. The data used to calibrate and evaluate three crop models were obtained from a field experiment with two irrigation amounts and two wheat cultivars that have different phenology and growth habit. After calibration, the model was applied to fifty locations across the wheat-growing area of the UK to cover all the main growing regions, with most points located in the main growing areas. Four GCMs, with two cultivars and five planting dates, were simulated at the end of the century. Results of this study showed that the UK potential wheat yield will increase by 2–8% under projected climate. Farmers will need to close such a gap in the future because it will have implications in terms of food security. Future climatic conditions might increase such a gap. Adaptation measures (e.g. moving the optimal planting time), along with climate-ready varieties bred for future conditions and with precision agriculture techniques can help to reduce this gap and ensure that the future actual UK wheat production will be close to the potential.
The end-Ordovician mass extinction, linked to a major glaciation, led to deep changes in Hirnantian–Rhuddanian biotas. The Hirnantia Fauna, the first of two Hirnantian survival brachiopod-dominated communities, characterizes the lower–mid Hirnantian deposits globally, and its distribution is essential to understand how the extinction took place. In this paper, we describe, illustrate, and discuss the first macrofossiliferous Hirnantia Fauna assemblage from Belgium, occurring in the Tihange Member of the Fosses Formation at Tihange (Huy), within the Central Condroz Inlier. Six fossiliferous beds have yielded a low-diversity, brachiopod-dominated association. In addition to the brachiopods (Eostropheodonta hirnantensis, Plectothyrella crassicosta, Hirnantia sp., and Trucizetina? sp.), one trilobite (Mucronaspis sp.), four pelmatozoans (Xenocrinus sp., Cyclocharax [col.] paucicrenulatus, Conspectocrinus [col.] celticus, and Pentagonocyclicus [col.] sp.), three graptolites (Cystograptus ancestralis, Normalograptus normalis, and ?Metabolograptus sp.), together with indeterminate machaeridians and bryozoans were identified. The graptolite assemblage, from the Akidograptus ascensus-Parakidograptus acuminatus Biozone, indicates an early Rhuddanian (Silurian) age, and thus, an unexpectedly late occurrence of a typical Hirnantia Fauna. This Belgian association may represent an additional example of relict Hirnantia Fauna in the Silurian, sharing characteristics with the only other known from Rhuddanian rocks at Yewdale Beck (Lake District, England), although reworking has not been completely ruled out. The survival of these Hirnantian taxa into the Silurian might be linked to delayed post-glacial effects of rising temperature and sea-level, which may have favored the establishment of refugia in these two particular regions that were paleogeographically close during the Late Ordovician–early Silurian.
Stretcher transport isolators provide mobile, high-level biocontainment outside the hospital for patients with highly infectious diseases, such as Ebola virus disease. Air quality within this confined space may pose human health risks.
Ambient air temperature, relative humidity, and CO2 concentration were monitored within an isolator during 2 operational exercises with healthy volunteers, including a ground transport exercise of approximately 257 miles. In addition, failure of the blower unit providing ambient air to the isolator was simulated. A simple compartmental model was developed to predict CO2 and H2O concentrations within the isolator.
In both exercises, CO2 and H2O concentrations were elevated inside the isolator, reaching steady-state values of 4434 ± 1013 ppm CO2 and 22 ± 2 mbar H2O in the first exercise and 3038 ± 269 ppm CO2 and 20 ± 1 mbar H2O in the second exercise. When blower failure was simulated, CO2 concentration exceeded 10 000 ppm within 8 minutes. A simple compartmental model predicted CO2 and H2O concentrations by accounting for human emissions and blower air exchange.
Attention to air quality within stretcher transport isolators (including adequate ventilation to prevent accumulation of CO2 and other bioeffluents) is needed to optimize patient safety.
Through consultation with foundation doctors on their psychiatry placements in Leeds, we established that they didn't feel the trustwide teaching programme met their needs, with them rating the relevance as 5.8 on a 1-10 Likert scale. They also reported their access to formal and informal teaching had been limited by COVID-19 restrictions. We aimed to create an accessible teaching programme that met their developmental needs as set out by the Foundation curriculum, as well as their confidence and skill set in dealing with common mental health presentations. Our supplementary aims were to promote psychiatry as a career and to provide supervised teaching opportunities to core trainees.
Having assessed the foundation doctors confidence in dealing with different scenarios, we created a 9 week teaching programme covering common mental health presentations they're likely to encounter during their training. The virtual sessions focus on what assessment and management skills would be expected for a foundation doctor, as well as when and how to access support and refer on. The programme was designed to be trainee led with the teaching being facilitated by core trainees as it was felt that they would best relate to the experiences and developmental needs of foundation doctors. This also provided the CTs with an opportunity to develop their teaching skills, something that has become more difficult during COVID.
Through weekly feedback of the sessions we were able to demonstrate that for 8 of the 9 sessions the foundation doctors rated them as being ‘useful’ or ‘very useful’ and we're currently reviewing the topic and materials for the outlying session.
Through self-assessed ratings before and after the programme, we demonstrated significant increases in confidence in dealing with all 9 of the scenarios. All of the foundation doctors indicated that they had found the programme beneficial.
As shown in the results, the programme has been well received by the foundation doctors who's confidence in dealing with a range of scenarios has improved. The programme has also been well received by the trust who have asked us to repeat the it for future foundation rotations and by core trainees who were grateful of the development opportunities that this provided. Further developments will include extending the programme for the duration of the placement to enable us to cover an enhanced range of presentations and to consolidate core skills.