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To determine the reliability of teleneuropsychological (TNP) compared to in-person assessments (IPA) in people with HIV (PWH) and without HIV (HIV−).
Participants included 80 PWH (Mage = 58.7, SDage = 11.0) and 23 HIV− (Mage = 61.9, SDage = 16.7). Participants completed two comprehensive neuropsychological IPA before one TNP during the COVID-19 pandemic (March–December 2020). The neuropsychological tests included: Hopkins Verbal Learning Test-Revised (HVLT-R Total and Delayed Recall), Controlled Oral Word Association Test (COWAT; FAS-English or PMR-Spanish), Animal Fluency, Action (Verb) Fluency, Wechsler Adult Intelligence Scale 3rd Edition (WAIS-III) Symbol Search and Letter Number Sequencing, Stroop Color and Word Test, Paced Auditory Serial Addition Test (Channel 1), and Boston Naming Test. Total raw scores and sub-scores were used in analyses. In the total sample and by HIV status, test-retest reliability and performance-level differences were evaluated between the two consecutive IPA (i.e., IPA1 and IPA2), and mean in-person scores (IPA-M), and TNP.
There were statistically significant test-retest correlations between IPA1 and IPA2 (r or ρ = .603–.883, ps < .001), and between IPA-M and TNP (r or ρ = .622–.958, ps < .001). In the total sample, significantly lower test-retest scores were found between IPA-M and TNP on the COWAT (PMR), Stroop Color and Word Test, WAIS-III Letter Number Sequencing, and HVLT-R Total Recall (ps < .05). Results were similar in PWH only.
This study demonstrates reliability of TNP in PWH and HIV−. TNP assessments are a promising way to improve access to traditional neuropsychological services and maintain ongoing clinical research studies during the COVID-19 pandemic.
In the face of global epidemics of mental ill-health, the future of social policy lies with promotion of public wellbeing. This article aims to provide an explanatory rationale and methods for a fundamental shift in social policy; away from a remedial focus on mental ill-health defined in terms of disease or aberrant behaviour and toward a focus on universal access to social conditions favourable to psychological wellbeing. The paper begins with prefacing argument about the urgent need for such a shift, noting the high rates of mental ill-health globally and the failure of current biomedical responses to reduce these. Building on recent theoretical work on public wellbeing and evidence on social determinants of mental health, the paper then proposes nine domains for social policy and broader public policy action, to create conditions supportive of wellbeing abilities. Finally, the paper presents several conceptual issues relating to the challenge of putting such action into practice and concludes that contemporary understanding of wellbeing offers a theory of change to shift social policy from mental illness to public wellbeing.
We summarize some of the past year's most important findings within climate change-related research. New research has improved our understanding about the remaining options to achieve the Paris Agreement goals, through overcoming political barriers to carbon pricing, taking into account non-CO2 factors, a well-designed implementation of demand-side and nature-based solutions, resilience building of ecosystems and the recognition that climate change mitigation costs can be justified by benefits to the health of humans and nature alone. We consider new insights about what to expect if we fail to include a new dimension of fire extremes and the prospect of cascading climate tipping elements.
A synthesis is made of 10 topics within climate research, where there have been significant advances since January 2020. The insights are based on input from an international open call with broad disciplinary scope. Findings include: (1) the options to still keep global warming below 1.5 °C; (2) the impact of non-CO2 factors in global warming; (3) a new dimension of fire extremes forced by climate change; (4) the increasing pressure on interconnected climate tipping elements; (5) the dimensions of climate justice; (6) political challenges impeding the effectiveness of carbon pricing; (7) demand-side solutions as vehicles of climate mitigation; (8) the potentials and caveats of nature-based solutions; (9) how building resilience of marine ecosystems is possible; and (10) that the costs of climate change mitigation policies can be more than justified by the benefits to the health of humans and nature.
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How do we limit global warming to 1.5 °C and why is it crucial? See highlights of latest climate science.
Growing evidence suggests that air pollution exposure may adversely affect the brain and increase risk for psychiatric disorders such as schizophrenia and depression. However, little is known about the potential role of air pollution in severity and relapse following illness onset.
To examine the longitudinal association between residential air pollution exposure and mental health service use (an indicator of illness severity and relapse) among individuals with first presentations of psychotic and mood disorders.
We identified individuals aged ≥15 years who had first contact with the South London and Maudsley NHS Foundation Trust for psychotic and mood disorders in 2008–2012 (n = 13 887). High-resolution (20 × 20 m) estimates of nitrogen dioxide (NO2), nitrogen oxides (NOx) and particulate matter (PM2.5 and PM10) levels in ambient air were linked to residential addresses. In-patient days and community mental health service (CMHS) events were recorded over 1-year and 7-year follow-up periods.
Following covariate adjustment, interquartile range increases in NO2, NOx and PM2.5 were associated with 18% (95% CI 5–34%), 18% (95% CI 5–34%) and 11% (95% CI 3–19%) increased risk for in-patient days after 1 year. Similarly, interquartile range increases in NO2, NOx, PM2.5 and PM10 were associated with 32% (95% CI 25–38%), 31% (95% CI 24–37%), 7% (95% CI 4–11%) and 9% (95% CI 5–14%) increased risk for CMHS events after 1 year. Associations persisted after 7 years.
Residential air pollution exposure is associated with increased mental health service use among people recently diagnosed with psychotic and mood disorders. Assuming causality, interventions to reduce air pollution exposure could improve mental health prognoses and reduce healthcare costs.
For more than a decade, Improving Access to Psychological Therapies (IAPT) has been training a new workforce of psychological therapists. Despite evidence of stress and burnout both in trainee mental health professionals, and qualified IAPT clinicians, little is known about these topics in IAPT trainees. Consequently, this systematic review sought to establish the current state of the literature regarding stress and burnout in IAPT trainees. Electronic databases were searched to identify all published and available unpublished work relating to the topic. On the basis of pre-established eligibility criteria, eight studies (including six unpublished doctoral theses) were identified and assessed for quality. This review identifies that research into the experience of IAPT trainees is under-developed. Existing evidence tentatively suggests that IAPT trainees may experience levels of stress and burnout that are higher than their qualified peers and among the higher end of healthcare professionals more generally. The experience of fulfilling dual roles as mental health professionals and university students concurrently appears to be a significant source of stress for IAPT trainees. More research regarding the levels and sources of stress and burnout in IAPT trainees is urgently needed to confirm and extend these findings. Recommendations for future research in the area are given.
Key learning aims
(1) To establish the current state of the literature regarding stress and burnout in IAPT trainees.
(2) To raise practitioner, service and education-provider awareness regarding the levels and perceived sources of stress and burnout in IAPT trainees.
(3) To make recommendations regarding future research on the topic.
ABSTRACT IMPACT: Investigation of tumor-associated blood vessels may serve as an imaging biomarker of response to systemic therapy and cancer outcomes. OBJECTIVES/GOALS: Aberrancies in the tumor microvasculature limit the systemic delivery of anticancer agents, which impedes tumor response. Using human intravital microscopy (HIVM), we hypothesized that HIVM would be feasible in patients with peritoneal carcinomatosis (PC) and generate clinical utility. METHODS/STUDY POPULATION: During cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for PC, HIVM was performed in both tumor and non-tumor areas. The primary outcome was HIVM feasibility to measure vessel characteristics. We secondarily evaluated associations between HIVM vessel characteristics and oncologic outcomes (RECIST response to neoadjuvant therapy and disease-specific survival). RESULTS/ANTICIPATED RESULTS: Thirty patients with PC were enrolled. Nineteen patients (63.3%) received neoadjuvant therapy. HIVM was feasible in all patients. Compared to non-tumor (control) areas, PC areas had a lower density of functional vessels, higher proportion of non-functional vessels, smaller lumenal diameters, and lower blood flow velocity. Qualitative differences in these vessel characteristics were observed among patients who had partial response, stable disease, or progressive disease after receiving neoadjuvant therapy. However, no statistically significant relationships were found between HIVM vessel characteristics and oncologic outcomes. DISCUSSION/SIGNIFICANCE OF FINDINGS: These novel findings comprise the first-in-human, real-time evidence of the microscopic differences between normal and tumor-associated vessels and form the basis for our larger, ongoing clinical trial appropriately powered to determine the clinical utility of HIVM (NCT03823144).
The present study used a longitudinal and discordant twin design to explore in depth the developmental associations between victimization and loneliness from mid-childhood to young adulthood. The data were drawn from the Environmental Risk (E-Risk) Longitudinal Twin Study, a birth cohort of 2,232 individuals born in England and Wales during 1994–1995. Diverse forms of victimization were considered, differing across context, perpetrator, and timing of exposure. The results indicated that exposure to different forms of victimization was associated with loneliness in a dose–response manner. In childhood, bullying victimization was uniquely associated with loneliness, over and above concurrent psychopathology, social isolation, and genetic risk. Moreover, childhood bullying victimization continued to predict loneliness in young adulthood, even in the absence of ongoing victimization. Within-twin pair analyses further indicated that this longitudinal association was explained by genetic confounds. In adolescence, varied forms of victimization were correlated with young adult loneliness, with maltreatment, neglect, and cybervictimization remaining robust to controls for genetic confounds. These findings indicate that vulnerability to loneliness in victimized young people varies according to the specific form of victimization in question, and also to the developmental period in which it was experienced.
Associations of socioenvironmental features like urbanicity and neighborhood deprivation with psychosis are well-established. An enduring question, however, is whether these associations are causal. Genetic confounding could occur due to downward mobility of individuals at high genetic risk for psychiatric problems into disadvantaged environments.
We examined correlations of five indices of genetic risk [polygenic risk scores (PRS) for schizophrenia and depression, maternal psychotic symptoms, family psychiatric history, and zygosity-based latent genetic risk] with multiple area-, neighborhood-, and family-level risks during upbringing. Data were from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative cohort of 2232 British twins born in 1994–1995 and followed to age 18 (93% retention). Socioenvironmental risks included urbanicity, air pollution, neighborhood deprivation, neighborhood crime, neighborhood disorder, social cohesion, residential mobility, family poverty, and a cumulative environmental risk scale. At age 18, participants were privately interviewed about psychotic experiences.
Higher genetic risk on all indices was associated with riskier environments during upbringing. For example, participants with higher schizophrenia PRS (OR = 1.19, 95% CI = 1.06–1.33), depression PRS (OR = 1.20, 95% CI = 1.08–1.34), family history (OR = 1.25, 95% CI = 1.11–1.40), and latent genetic risk (OR = 1.21, 95% CI = 1.07–1.38) had accumulated more socioenvironmental risks for schizophrenia by age 18. However, associations between socioenvironmental risks and psychotic experiences mostly remained significant after covariate adjustment for genetic risk.
Genetic risk is correlated with socioenvironmental risk for schizophrenia during upbringing, but the associations between socioenvironmental risk and adolescent psychotic experiences appear, at present, to exist above and beyond this gene-environment correlation.
Pinnacle Point (PP) near Mossel Bay in the Western Cape Province, South Africa, is known for a series of archaeological caves with important archaeological finds. Extensive excavations and studies in two of them (PP13B and PP5-6) have documented alternating periods of anthropogenic-dominated and geogenic-dominated sedimentation. A variety of caves do not bear evidence of anthropogenic remains. We have studied in detail the remnant deposits of three of them, Staircase Cave, Crevice Cave, and PP29, which have been formed under the same geologic and sedimentary conditions with those with anthropogenic contributions. Their remains are small and patchy but have extensive speleothem formations (as do most caves at PP) that were isotopically analyzed for paleoclimate and paleoenvironmental reconstruction. These caves also offer the opportunity to understand the purely geogenic signature of the PP locality and thus offer a geogenic baseline for the anthropogenic caves. Archaeologists normally focus only on sites with strong anthropogenic signals, but by building cave life histories we “raise the bar” (Goldberg 2008, p. 30) on our contextual knowledge.
In recent years, there has been increased use of dicamba due to the introduction of dicamba-resistant cotton and soybean in the United States. Therefore, there is a potential increase in off-target movement of dicamba and injury to sensitive crops. Flue-cured tobacco is extremely sensitive to auxin herbicides, particularly dicamba. In addition to yield loss, residue from drift or equipment contamination can have severe repercussions for the marketability of the crop. Studies were conducted in 2016, 2017, and 2018 in North Carolina to evaluate spray-tank cleanout efficiency of dicamba using various cleaning procedures. No difference in dicamba recovery was observed regardless of dicamba formulation and cleaning agent. Dicamba residue decreased with the number of rinses. There was no difference in dicamba residue recovered from the third rinse compared with residue from the tank after being refilled for subsequent tank use. Recovery ranged from 2% to 19% of the original concentration rate among the three rinses. Field studies were also conducted in 2018 to evaluate flue-cured tobacco response to reduced rates of dicamba ranging, from 1/5 to 1/10,000 of a labeled rate. Injury and yield reductions varied by environment and application timing. When exposed to 1/500 of a labeled rate at 7 and 11 wk after transplanting, tobacco injury ranged from 39% to 53% and 10% to 16% 24 days after application, respectively. The maximum yield reduction was 62%, with a 55% reduction in value when exposed to 112 g ha−1 of dicamba. Correlations showed significant relationships between crop injury assessment and yield and value reductions, with Pearson values ranging from 0.24 to 0.63. These data can provide guidance to growers and stakeholders and emphasize the need for diligent stewardship when using dicamba technology.
Currently, there are seven herbicides labeled for U.S. tobacco production; however, additional modes of action are greatly needed in order to reduce the risk of herbicide resistance. Field experiments were conducted at five locations during the 2017 and 2018 growing seasons to evaluate flue-cured tobacco tolerance to S-metolachlor applied pretransplanting incorporated (PTI) and pretransplanting (PRETR) at 1.07 (1×) and 2.14 (2×) kg ai ha−1. Severe injury was observed 6 wk after transplanting at the Whiteville environment in 2017 when S-metolachlor was applied PTI. End-of-season plant heights from PTI treatments at Whiteville were likewise reduced by 9% to 29% compared with nontreated controls, although cured leaf yield and value were reduced only when S-metolachlor was applied PTI at the 2× rate. Severe growth reduction was also observed at the Kinston location in 2018 where S-metolachlor was applied at the 2× rate. End-of-season plant heights were reduced 11% (PTI, 2×) and 20% (PRETR, 2×) compared with nontreated control plants. Cured leaf yield was reduced in Kinston when S-metolachlor was applied PRETR at the 2× rate; however, treatments did not impact cured leaf quality or value. Visual injury and reductions in stalk height, yield, quality, and value were not observed at the other three locations. Ultimately, it appears that injury potential from S-metolachlor is promoted by coarse soil texture and high early-season precipitation close to transplanting, both of which were documented at the Whiteville and Kinston locations. To reduce plant injury and the negative impacts to leaf yield and value, application rates lower than 1.07 kg ha−1 may be required in these scenarios.
Medieval historiography in Britain was written in all of the languages of the island. Latin and vernacular texts engaged in sophisticated intertextual dialogues throughout the period. This essay considers how vernacular history writing deployed its vernacularity to make political and imaginative interventions in the dominant traditions of historiography. The essay surveys how the Middle English chronicles of Robert of Gloucester, Robert Mannyng, and the Short Chronicle, and the Anglo-Norman chronicles of Piers Langtoft and Nicholas Trevet engaged with ideas of intertextuality, authority, citation, and translation in order to craft narratives of insular history often at odds with each other.
This article reviews the Southern Illinois Twins/Triplets and Siblings Study (SITSS) and describes some of the findings related to recent projects that were completed using this sample. At this time, the SITSS has enrolled 375 twin pairs, 12 triplet families, 1 family of quadruplets, 98 nontwin sibling pairs and 287 singletons. Testing begins for twins and triplets as young as age 1 and then occurs yearly on their birthdays until 5 years of age. Through age 20, various follow-up studies have been conducted on the SITSS sample to examine their social, emotional, and cognitive development across childhood and adolescence from a behavioral genetic perspective. A variety of methodologies have been used to investigate gene–environment correlations (rGE) and gene–environment interactions (GxE). Advanced statistical procedures (e.g., genetic likelihood indices and multilevel modeling) have been utilized to further investigate genetic underpinnings of behavior. Recent results have indicated genetic influences on the aggressiveness of preschoolers’ media preferences, increased problem behaviors related to young children’s overestimation of self-competence, and the influence of early life temperament and internalizing problems on adolescent health behaviors. Additionally, the SITSS has provided evidence for evocative rGE for various behaviors (aggression, prosocial and play), as well as findings supporting interactions between the dopamine receptor D4 gene (DRD4) and the environment (peer victimization, prenatal birth complications and parental sensitivity). Together, by use of multitrait and multimethodological investigations, this behavior genetic data set assists in furthering our understanding of biological and environmental influences on children’s development.
Highly resolved, well-dated paleoclimate records from the southern South African coast are needed to contextualize the evolution of the highly diverse extratropical plant communities of the Greater Cape Floristic Region (GCFR) and to assess the environmental impacts on early human hunter-gatherers. We present new speleothem stable oxygen and carbon isotope ratios (δ18Oc and δ13C) from two caves at Pinnacle Point, South Africa, covering the time between 330 and 43 ka. Composite δ18Oc and δ13C records were constructed for Staircase Cave and PP29 by combining all stable isotope analyses into a single time series and smoothing by a 3-point running mean. δ18Oc and δ13C values record changes in rainfall seasonality and the proportions of C3 and C4 plants in the vegetation, respectively. We show that in general increased summer rainfall brought about a wider spread of C4 grasses and retreat of the C3 plant–dominated GCFR communities. The occurrence of summer rainfall on the southern coast of South Africa was linked to total rainfall amounts in the interior region through tropical temperate troughs. These rainfall systems shifted the southern coastal climate toward more summer (winter) rainfall when precession was high (low) and/or the westerlies were in a northern (southern) position.
The paper analyses the policy process which enabled the successful adoption of Australia's National Aboriginal and Torres Strait Islander Health Plan 2013–2023 (NATSIHP), which is grounded in an understanding of the Social Determinants of Indigenous Health (SDIH). Ten interviews were conducted with key policy actors directly involved in its development. The theories we used to analyse qualitative data were the Advocacy Coalition Framework, the Multiple Streams Approach, policy framing and critical constructionism. We used a complementary approach to policy analysis. The NATSIHP acknowledges the importance of Aboriginal and Torres Strait Islander (hereafter, Aboriginal) culture and the health effects of racism, and explicitly adopts a human-rights-based approach. This was enabled by a coalition campaigning to ‘Close the Gap’ (CTG) in health status between Aboriginal and non-Aboriginal Australians. The CTG campaign, and key Aboriginal health networks associated with it, operated as an effective advocacy coalition, and policy entrepreneurs emerged to lead the policy agenda. Thus, Aboriginal health networks were able to successfully contest conventional problem conceptions and policy framings offered by government policy actors and drive a paradigm shift for Aboriginal health to place SDIH at the centre of the NATSIHP policy. Implications of this research for policy theory and for other policy environments are considered along with suggestions for future research.
The aim of this study was to build a detailed, integrative profile of the correlates of young adults’ feelings of loneliness, in terms of their current health and functioning and their childhood experiences and circumstances.
Data were drawn from the Environmental Risk Longitudinal Twin Study, a birth cohort of 2232 individuals born in England and Wales in 1994 and 1995. Loneliness was measured when participants were aged 18. Regression analyses were used to test concurrent associations between loneliness and health and functioning in young adulthood. Longitudinal analyses were conducted to examine childhood factors associated with young adult loneliness.
Lonelier young adults were more likely to experience mental health problems, to engage in physical health risk behaviours, and to use more negative strategies to cope with stress. They were less confident in their employment prospects and were more likely to be out of work. Lonelier young adults were, as children, more likely to have had mental health difficulties and to have experienced bullying and social isolation. Loneliness was evenly distributed across genders and socioeconomic backgrounds.
Young adults’ experience of loneliness co-occurs with a diverse range of problems, with potential implications for health in later life. The findings underscore the importance of early intervention to prevent lonely young adults from being trapped in loneliness as they age.
This article describes the study design of Parenting Today in Victoria: a representative survey of contemporary parenting experiences, behaviours, concerns and needs of parents. The aims of the study, sample design, survey content development processes, including pilot survey administration, data collection procedures and demographic characteristics of the sample are described. The survey was administered via computer assisted telephone interviewing using random dialling of landline and mobile phone numbers in 2016 to parents of children aged 0–18 years who were living in Victoria, Australia. The response rate was 57% with 2600 parents surveyed (40% fathers). The sample was broadly representative of the Victorian population on major demographic characteristics when compared to data from the Australian Census of Population and Housing (Australian Bureau of Statistics, 2011). However, adjustments were made for over representation of younger parents (16–34 years), more highly educated parents and for those living outside major cities. This survey provides rigorously collected, accurate and up-to-date information about the experiences, preferences and concerns of a large and representative sample of parents. Findings will provide vital new insights to inform policy decision making, service planning and future research aimed at understanding parents’ attitudes and behaviours, and the psychology behind their help-seeking.
Much of the controversy that has surrounded the study of receptaculitids has been associated, in one way or another, with difficulties in reconstructing their mode of growth. Many of these difficulties, in turn, result from inadequate comparative morphological analysis and a consequent ambiguity in relating the results of work on one taxon to arguments framed in the context of another. In order to deal with this aspect of the controversy, we propose a standardization of anatomical orientation for receptaculitids, based on features that we argue are homologous, taxonomically widespread, and useful as criteria of polarity. These include: overall thallus shape; morphology and arrangement of intercalary meroms; latitudinal gradients in number of meroms per whorl; articular relationships of stellate structures; and imbrication of merom plates. This standardization will contribute to an understanding of growth and life orientation in receptaculitids by acting as an arbiter of the consistency of growth analyses performed on morphologically disparate taxa.