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Emotional functioning is linked to HIV-associated neurocognitive impairment, yet research on this association among diverse people with HIV (PWH) is scant. We examined emotional health and its association with neurocognition in Hispanic and White PWH.
Participants included 107 Hispanic (41% primarily Spanish-speakers; 80% Mexican heritage/origin) and 216 White PWH (Overall age: M = 53.62, SD = 12.19; 86% male; 63% AIDS; 92% on antiretroviral therapy). Emotional health was assessed via the National Institute of Health Toolbox (NIHTB)-Emotion Battery, which yields T-scores for three factor-based summary scores (negative affect, social satisfaction, and psychological well-being) and 13 individual component scales. Neurocognition was measured via demographically adjusted fluid cognition T-scores from the NIHTB-cognition battery.
27%–39% of the sample had problematic socioemotional summary scores. Hispanic PWH showed less loneliness, better social satisfaction, higher meaning and purpose, and better psychological well-being than Whites (ps <.05). Within Hispanics, Spanish-speakers showed better meaning and purpose, higher psychological well-being summary score, less anger hostility, but greater fear affect than English speakers. Only in Whites, worse negative affect (fear affect, perceived stress, and sadness) was associated with worse neurocognition (p <.05); and in both groups, worse social satisfaction (emotional support, friendship, and perceived rejection) was linked with worse neurocognition (p <.05).
Adverse emotional health is common among PWH, with subgroups of Hispanics showing relative strengths in some domains. Aspects of emotional health differentially relate to neurocogntition among PWH and cross-culturally. Understanding these varying associations is an important step towards the development of culturally relevant interventions that promote neurocognitive health among Hispanic PWH.
The Hierarchical Taxonomy of Psychopathology (HiTOP) has emerged out of the quantitative approach to psychiatric nosology. This approach identifies psychopathology constructs based on patterns of co-variation among signs and symptoms. The initial HiTOP model, which was published in 2017, is based on a large literature that spans decades of research. HiTOP is a living model that undergoes revision as new data become available. Here we discuss advantages and practical considerations of using this system in psychiatric practice and research. We especially highlight limitations of HiTOP and ongoing efforts to address them. We describe differences and similarities between HiTOP and existing diagnostic systems. Next, we review the types of evidence that informed development of HiTOP, including populations in which it has been studied and data on its validity. The paper also describes how HiTOP can facilitate research on genetic and environmental causes of psychopathology as well as the search for neurobiologic mechanisms and novel treatments. Furthermore, we consider implications for public health programs and prevention of mental disorders. We also review data on clinical utility and illustrate clinical application of HiTOP. Importantly, the model is based on measures and practices that are already used widely in clinical settings. HiTOP offers a way to organize and formalize these techniques. This model already can contribute to progress in psychiatry and complement traditional nosologies. Moreover, HiTOP seeks to facilitate research on linkages between phenotypes and biological processes, which may enable construction of a system that encompasses both biomarkers and precise clinical description.
Given the aging population of people with HIV (PWH), along with increasing rates of binge drinking among both PWH and the general older adult population, this study examined the independent and interactive effects of HIV, binge drinking, and age on neurocognition.
Participants were 146 drinkers stratified by HIV and binge drinking status (i.e., ≥4 drinks for women and ≥5 drinks for men within approximately 2 h): HIV+/Binge+ (n = 30), HIV−/Binge+ (n = 23), HIV+/Binge− (n = 55), HIV−/Binge− (n = 38). All participants completed a comprehensive neuropsychological battery measuring demographically-corrected global and domain-specific neurocognitive T scores. ANCOVA models examined independent and interactive effects of HIV and binge drinking on neurocognitive outcomes, adjusting for overall alcohol consumption, lifetime substance use, sex, and age. Subsequent multiple linear regressions examined whether HIV/Binge group moderated the relationship between age and neurocognition.
HIV+/Binge+ participants had worse global neurocognition, processing speed, delayed recall, and working memory than HIV−/Binge− participants (p’s < .05). While there were significant main effects of HIV and binge drinking, their interaction did not predict any of those neurocognitive outcomes (p’s > .05). Significant interactions between age and HIV/Binge group showed that HIV+/Binge+ participants demonstrated steeper negative relationships between age and neurocognitive outcomes of learning, delayed recall, and motor skills compared to HIV−/Binge− participants (p’s < .05).
Results showed adverse additive effects of HIV and binge drinking on neurocognitive functioning, with older adults demonstrating the most vulnerability to these effects. Findings support the need for interventions to reduce binge drinking, especially among older PWH.
Recent cannabis exposure has been associated with lower rates of neurocognitive impairment in people with HIV (PWH). Cannabis’s anti-inflammatory properties may underlie this relationship by reducing chronic neuroinflammation in PWH. This study examined relations between cannabis use and inflammatory biomarkers in cerebrospinal fluid (CSF) and plasma, and cognitive correlates of these biomarkers within a community-based sample of PWH.
263 individuals were categorized into four groups: HIV− non-cannabis users (n = 65), HIV+ non-cannabis users (n = 105), HIV+ moderate cannabis users (n = 62), and HIV+ daily cannabis users (n = 31). Differences in pro-inflammatory biomarkers (IL-6, MCP-1/CCL2, IP-10/CXCL10, sCD14, sTNFR-II, TNF-α) by study group were determined by Kruskal–Wallis tests. Multivariable linear regressions examined relationships between biomarkers and seven cognitive domains, adjusting for age, sex/gender, race, education, and current CD4 count.
HIV+ daily cannabis users showed lower MCP-1 and IP-10 levels in CSF compared to HIV+ non-cannabis users (p = .015; p = .039) and were similar to HIV− non-cannabis users. Plasma biomarkers showed no differences by cannabis use. Among PWH, lower CSF MCP-1 and lower CSF IP-10 were associated with better learning performance (all ps < .05).
Current daily cannabis use was associated with lower levels of pro-inflammatory chemokines implicated in HIV pathogenesis and these chemokines were linked to the cognitive domain of learning which is commonly impaired in PWH. Cannabinoid-related reductions of MCP-1 and IP-10, if confirmed, suggest a role for medicinal cannabis in the mitigation of persistent inflammation and cognitive impacts of HIV.
To assess the feasibility and utility of introducing the following changes on to in-patient units:
Structural and cultural adaptation to create a sleep friendly ward environment
A “Protected Sleep Time” between midnight and 6am
Routine screening for sleep disorders, including obstructive sleep apnoea and restless leg syndrome
Insomnia and other sleep disturbances are cause, correlate and consequence of psychiatric disorders. Routine hourly night time observations, ward noise, bright lights at night time, sleep disorders, insufficient exercise, insufficient day light exposure, too much caffeine and inappropriate psychotropic use are all causes of disturbed sleep (Horne 2018).
Seven wards participated in a pilot (SleepWell). These consisted of one male and two female Acute Wards (General Adult), a High Dependency Unit, a Neurorehabilitation ward, an in-patient dementia service and one rehabilitation ward. These wards were supported via an existing trust management structure and the pilot was specifically supported by two trust managers (RW and RB) and by a clinical director (PK). The expectation was that each ward would identify a sleep champion from existing staff to facilitate the changes. A “product” was developed which identified core sleep management features but, in addition, wards were not confined to these. The existing policy that all inpatients should be checked each hour over night was suspended for the pilot wards and the patients had protected sleep time (PST) if the MDT agreed that it was clinically appropriate.
Quantitative and qualitative techniques were used to identify facilitators of change, impact on sleep and, outcome.
Protected sleep was viewed positively by all staff and approximately 50% of patients on the pilot wards were able to have PST at some point in their admission. Routine sleep disorder assessments were harder to implement and 33% of patients were screened. There were no deaths or significant events on patients due to PST. Hypnotic use on the pilot wards reduced. It is anticipated that PST where it is safe will be rolled out across all adult and old age wards in the trust.
With support, it has been feasible to change many aspects of sleep management across a breadth of inpatient units in a large NHS trust.
The purpose of this article is to describe the process of developing and implementing a transdisciplinary community-based research center, the Center for Health Equity Research (CHER) Chicago, to offer a model for designing and implementing research centers that aim to address structural causes of health inequality.
Scholars from diverse backgrounds and disciplines formed a multidisciplinary team for the Center and adopted the structural violence framework as the organizing conceptual model. All Center activities were based on community partnership. The Center activities were organized within three cores: administrative, investigator development, and community engagement and dissemination cores. The key activities during the first year were to develop a pilot grant program for early-stage investigators (ESIs) and to establish community partnership mechanisms.
CHER provided more than 60 consultations for ESIs, which resulted in 31 pilot applications over the three application cycles. Over 200 academic and community partners attended the community symposium and discussed community priority. Some challenges encountered were to improve communication among investigators, to clarify roles and responsibilities of the three cores, and to build consensus on the definition and operationalization of the concept of structural violence.
There is an increasing need for local hubs to facilitate transdisciplinary collaboration and community engagement to effectively address health inequity. Building consensus around a shared vision among partners is a difficult and yet important step toward achieving equity.
Perfectionism is a transdiagnostic risk factor across psychopathology. The Clinical Perfectionism Questionnaire (CPQ) was developed to assess change in order to provide clinical utility, but currently the psychometric properties of the CPQ with adolescents is unknown.
To assess the factor structure and construct validity of the CPQ in female adolescents.
The CPQ was administered to 267 females aged 14–19 years of age. Confirmatory factor analysis (CFA) was used to examine the validity of the two-factor model and a second-order factor model. Pearson correlations were used to evaluate the relationships between the CPQ and a wide range of measures of perfectionism, psychopathology and personality traits.
The study demonstrated internal consistency, construct validity and incremental validity of the CPQ in a sample of female adolescents. The CFA in the present study confirmed the two-factor model of the CPQ with Factor 1 relating to perfectionistic strivings and Factor 2 representing perfectionistic concerns. The second-order two factor model indicated no deterioration in fit.
The two-factor model of the CPQ fits with the theoretical definition of clinical perfectionism where the over-dependence of self-worth on achievement and concern over mistakes are key elements. The CPQ is suitable for use with female adolescents in future research that seeks to better understand the role of perfectionism in the range of mental illnesses that impact youth.
Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons (MIC). We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.
Highly anomalous platinum-group element (PGE) concentrations in the podiform chromitites at the Cliff and Harold's Grave localities in the Shetland ophiolite complex have been well documented previously. The focus of this study is alluvial platinum-group minerals (PGM) located in small streams that drain from the PGE-rich chromitites. The placer PGM assemblage at Cliff is dominated by Pt-arsenides (64%) and Pd-antimonides (17%), with less irarsite–hollingworthite (11%) and minor Pd-sulfides, Pt–Pd–Cu and Pt–Fe alloys and laurite. Gold also occurs with the PGM. Alluvial PGM have average sizes of 20 µm × 60 µm, with sperrylite the largest grain identified at 110 µm in diameter, matching the range reported for the primary PGM in the source rocks. The placer assemblage contains more Pt-bearing and less Pd-bearing PGM compared with the rocks. The more resistant sperrylite and irarsite–hollingworthite grains which are often euhedral become more rounded further downstream whereas the less resistant Pd-antimonides which are commonly subhedral may become striated and etched. Less stable phases such as Pt- and Pd-oxides and other Ni-Cu-bearing phases located in the rocks (i.e. Ru-pentlandite, PtCu, Pd–Cu alloy) are absent in the placer assemblage. Also the scarce PGM (PdHg, Rh- and Ir-Sb) and Os in the rocks are absent. At Harold's Grave only three alluvial PGM (laurite, Ir, Os) and Au were recovered reflecting the limited release of IPGM from chromite grains in the rocks. In this cold climate with high rainfall, where erosion dominates over weathering, the PGM appear to have been derived directly from the erosion of the adjacent PGE-rich source rocks and there is little evidence of in situ growth of any newly formed PGM. Only the presence of dendritic pure Au and Pd-, Cu-bearing Au covers on the surface of primary minerals may indicate some local reprecipitation of these metals in the surficial conditions.
While the use of formal trauma teams is widely promoted, the literature is not clear that this structure provides improved outcomes over emergency physician delivered trauma care. The goal of this investigation was to examine if a trauma team model with a formalized, specialty-based trauma team, with specific activation criteria and staff composition, performs differently than an emergency physician delivered model. Our primary outcome was survival to discharge or 30 days.
An observational registry-based study using aggregate data from both the New Brunswick and Nova Scotia trauma registries was performed with data from April 1, 2011 to March 31, 2013. Inclusion criteria included patients 16 years-old and older who had an Injury Severity Score greater than 12, who suffered a kinetic injury and arrived with signs of life to a level-1 trauma centre.
266 patients from the trauma team model and 111 from the emergency physician model were compared. No difference was found in the primary outcome of proportion of survival to discharge or 30 days between the two systems (0.88, n=266 vs. 0.89, n=111; p=0.8608).
We were unable to detect any difference in survival between a trauma team and an emergency physician delivered model.
Policy-makers and practitioners have a need to assess community resilience in disasters. Prior efforts conflated resilience with community functioning, combined resistance and recovery (the components of resilience), and relied on a static model for what is inherently a dynamic process. We sought to develop linked conceptual and computational models of community functioning and resilience after a disaster.
We developed a system dynamics computational model that predicts community functioning after a disaster. The computational model outputted the time course of community functioning before, during, and after a disaster, which was used to calculate resistance, recovery, and resilience for all US counties.
The conceptual model explicitly separated resilience from community functioning and identified all key components for each, which were translated into a system dynamics computational model with connections and feedbacks. The components were represented by publicly available measures at the county level. Baseline community functioning, resistance, recovery, and resilience evidenced a range of values and geographic clustering, consistent with hypotheses based on the disaster literature.
The work is transparent, motivates ongoing refinements, and identifies areas for improved measurements. After validation, such a model can be used to identify effective investments to enhance community resilience. (Disaster Med Public Health Preparedness. 2018;12:127–137)
The plant pathogenic fungus Colletotrichum coccodes (Cc) and the plant growth regulator thidiazuron (TDZ) were evaluated in Maryland and Quebec for velvetleaf control in ‘Williams' and ‘Maple Arrow’ soybean. TDZ was applied at 0, 0.1, 0.2, 0.3, and 0.4 kg ai/ha alone or was combined with Cc at 109 spores/m2 when velvetleaf was at the 1- to 2-leaf (Trial 1) or 4- to 6-leaf (Trial 2) growth stages. Velvetleaf control increased with TDZ rate, and TDZ combined with Cc further increased control. TDZ reduced velvetleaf biomass and height, and Cc increased velvetleaf mortality. In Quebec, Cc also reduced the biomass of velvetleaf treated in Trial 1 and interacted positively with TDZ at this growth stage. Cc nearly halved the rates of TDZ required for 90 and 75% mortality of velvetleaf treated at the 1- to 2-leaf and 4- to 6-leaf stages to 0.09 and 0.12 kg/ha, respectively, in Quebec. Cc similarly lowered the rate of TDZ required for 75% stand reduction of velvetleaf in Trial 1 to 0.17 kg/ha in Maryland. Cool wet weather in Quebec contrasted with warm, dry weather in Maryland. Soybean biomass and yield were increased significantly by treatment with TDZ plus Cc in Trial 1 at both locations.
Jointed goatgrass is an important weed of wheat in the United States and other parts of the world. Under field conditions, wheat and jointed goatgrass can hybridize and produce backcross derivatives, a situation that may allow gene flow between these two species. In order to gain a better understanding of the factors governing gene flow, a study to characterize patterns of mating between these two species was undertaken. Chloroplast and nuclear microsatellite markers were used to evaluate the parentage of 413 first-generation backcross (BC1) seeds obtained from 127 wheat–jointed goatgrass F1 hybrids, produced naturally under field conditions. Of the 127 hybrids evaluated, 109 (85.8%) had jointed goatgrass as the female parent, whereas the remaining 18 F1 plants (14.2%) had wheat as the female parent. Of the 413 BC1 plants analyzed, 358 (86.7%) had wheat and 24 (5.8%) had jointed goatgrass as the male backcross parent. The male parentage of 31 BC1 (7.5%) plants could not be determined. Under natural field conditions, wheat was the prevalent pollen donor for the production of hybrids and first-generation backcross derivatives. However, hybrids and backcrosses with jointed goatgrass as the male parent also were observed. Thus, the establishment and persistence of a zone of hybridization between these species would result in the development of jointed goatgrass carrying wheat genes.
Production systems based on reduced-tillage practices account for over 60% of the cropped land on the Canadian Prairies. Concerns have been expressed regarding potential shifts in weed communities as a result of changing tillage practices. Study objectives were to (1) determine the feasibility of combining and analyzing weed abundance data from 10 medium- to long-term studies on the Canadian Prairies that compared conventional-, reduced-, and zero-tillage systems, (2) identify species that are associated with specific tillage systems, and (3) place species into plant response groups according to the similarity of their tillage system response. Conventional-tillage systems were defined as including both a fall and spring sweep-plow operation before seeding spring crops, whereas reduced tillage consisted of only one sweep-plow operation shortly before seeding. Crops within zero-tillage systems were planted directly into the previous crop's stubble. The association between weed species and tillage systems was investigated using indicator species analysis. Species were assigned to tillage response groups on the basis of the results of the analysis and the expertise of the project scientists. Perennial species such as Canada thistle and perennial sowthistle were associated with reduced- and zero-tillage systems, but annual species were associated with a range of tillage systems. Field pennycress was placed in the conventional-tillage response group, Russian thistle in the zero-tillage group, and wild buckwheat and common lambsquarters were equally abundant in all tillage systems. The goal of classifying weed species based on common functional traits in relation to responses to tillage systems was not realized, in part, because the required information on species biology and ecology was either unavailable or not applicable to local conditions.
Geothermal heat flux (GHF) is one of the key thermal boundary conditions for ice-sheet models. We assess the sensitivity of the Lambert-Amery glacial system in East Antarctica to four different GHF datasets using a regional ice-sheet model. A control solution of the regional model is initialised by minimising the misfit to observations through an optimisation process. The Lambert-Amery glacial system simulation contains temperate ice up to 150 m thick and has an average basal melt of 1.3 mm a−1, with maximum basal melting of 504 mm a−1. The simulations which use a relatively high GHF compared to the control solution increase the volume and area of temperate ice, which causes higher surface velocities at higher elevations, which leads to the advance of the grounding line. The grounding line advance leads to changes in the local flow configuration, which dominates the changes within the glacial system. To investigate the difference in spatial patterns within the geothermal datasets, they were scaled to have the same median value. These scaled GHF simulations showed that the ice flow was most sensitive to the spatial variation in the underlying GHF near the ice divides and on the edges of the ice streams.
Perfectionism is a risk and maintaining factor across psychopathology and has been proposed to be a transdiagnostic process. The aim of this study was to examine the reliability and validity of the Clinical Perfectionism Questionnaire (CPQ) in 32 adults (75% female, M age = 35.54 years, SD = 9.71) with a range of psychological disorders, presenting for treatment of clinical perfectionism. There was evidence that the CPQ was correlated with established measures of perfectionism and theoretically related constructs including self-criticism and dichotomous thinking. The CPQ was also able to predict treatment outcome. The internal consistency was not adequate in the current study; however, the sample size was small. Future studies should examine the psychometric properties of the CPQ in a larger sample of individuals with a range of psychological disorders.
The celebration of an individual human birthday is an almost completely one-sided recapitulation of pleasant experiences in earlier years, together with a warmly optimistic forecast for coming years. This is wholly right and proper, although even here an occasional muted warning is of genuine value.
The celebration of a “technological birthday”, the review of the partial success, through one or more years of operation, of a man-sustained project, deserves notice of the same general type of review, promising further success, warning of potential difficulty, hoping for circumstances and facilities favourable to continued satisfaction, continuously qualified by mention of possible—indeed probable— change in the social climate, for good or ill.
Percolation of blood and of interstitial fluids into implantable continuous glucose sensors (CGS) for diabetics presently limits sensor lifetime between 3 and 7 days. Na+ mobile ions in body fluids damage Si-based CGS sensors electronics. The direct detection of Na percolation is investigated by Ion Beam Analysis (IBA) and Proton Induced X-ray Emission (PIXE) in previously used CGS. Based on these results, a new technology called HemaDropTM is then tested to prepare small volume (5-10 µL) of blood for IBA. A species’s detectability by IBA scales with the square of the ratio of element’s atomic number Z to that of the substrate. Because Na has a low atomic number (Z=11), Si signals from sensor substrates can prevent Na detection in Si by 2 mega electron volt (MeV) IBA.
Using 4.7 MeV 23Na (α, α)23Na nuclear resonance (NR) can increase the 23Na scattering cross section and thus its detectability in Si. The NR energy, width, and resonance factor, is calibrated via two well-known alpha (α) particle signals with narrow energy spreads: a 5.486 ± 0.007 MeV 241Am α-source (ΔΕ = 0.12%) and the 3.038 ± 0.003 MeV 16O(α, α)16O NR (ΔΕ = 0.1%). Next, the NR cross section is calibrated via 100 nm NaF thin films on Si(100) by scanning the beam energy. The23Na (α, α) NR energy is found to be 4.696 ± 0.180 MeV, and the NR/RBS cross section 141 ± 7%. This is statistically significant but small compared to the 4.265 MeV 12C NR (1700%) and 3.038 MeV 16O NR (210%), and insufficient to detect small amounts of 23Na in Si. Next, a new method of sample preparation HemaDropTM, is tested for detection of elements in blood, such Fe, Ca, Na, Cl, S, K, C, N, and O, as an alternative to track fluid percolation and Na diffusion in damaged sensors. Detecting more abundant, heavier elements in blood and interstitial fluids can better track fluid percolation and Na+ ions in sensors. Both Na detection and accuracy of measured blood composition by IBA is greatly improved by using HemaDropTM sample preparation to create Homogeneous Thin Solid Films (HTSFs) of blood from 5-10 µL on most substrates. HTSF can be used in vacuo such as 10-8 –10-6 Torr).