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Despite an elevated risk of psychopathology stemming from COVID-19-related stress, many essential workers stigmatise and avoid psychiatric care. This randomised controlled trial was designed to compare five versions of a social-contact-based brief video intervention for essential workers, differing by protagonist gender and race/ethnicity.
Aims
We examined intervention efficacy on treatment-related stigma (‘stigma’) and openness to seeking treatment (‘openness’), especially among workers who had not received prior mental healthcare. We assessed effectiveness and whether viewer/protagonist demographic concordance heightened effectiveness.
Method
Essential workers (N = 2734) randomly viewed a control video or brief video of an actor portraying an essential worker describing hardships, COVID-related anxiety and depression, and psychotherapy benefits. Five video versions (Black/Latinx/White and male/female) followed an identical 3 min script. Half the intervention group participants rewatched their video 14 days later. Stigma and openness were assessed at baseline, post-intervention, and at 14- and 30-day follow-ups. Trial registration: NCT04964570.
Results
All video intervention groups reported immediately decreased stigma (P < 0.0001; Cohen's d = 0.10) and increased openness (P < 0.0001; d = 0.23). The initial increase in openness was largely maintained in the repeated-video group at day 14 (P < 0.0001; d = 0.18), particularly among viewers without history of psychiatric treatment (P < 0.0001; d = 0.32). Increases were not sustained at follow-up. Female participants viewing a female protagonist and Black participants viewing a Black protagonist demonstrated greater openness than other demographic pairings.
Conclusions
Brief video-based interventions improved immediate stigma and openness. Greater effects among female and Black individuals viewing demographically matched protagonists emphasise the value of tailored interventions, especially for socially oppressed groups. This easily disseminated intervention may proactively increase care-seeking, encouraging treatment among workers in need. Future studies should examine intervention mechanisms and whether linking referrals to psychiatric services generates treatment-seeking.
Transforming towards global sustainability requires a dramatic acceleration of social change. Hence, there is growing interest in finding ‘positive tipping points’ at which small interventions can trigger self-reinforcing feedbacks that accelerate systemic change. Examples have recently been seen in power generation and personal transport, but how can we identify positive tipping points that have yet to occur? We synthesise theory and examples to provide initial guidelines for creating enabling conditions, sensing when a system can be positively tipped, who can trigger it, and how they can trigger it. All of us can play a part in triggering positive tipping points.
Technical summary
Recent work on positive tipping points towards sustainability has focused on social-technological systems and the agency of policymakers to tip change, whilst earlier work identified social-ecological positive feedbacks triggered by diverse actors. We bring these together to consider positive tipping points across social-technological-ecological systems and the potential for multiple actors and interventions to trigger them. Established theory and examples provide several generic mechanisms for triggering tipping points. From these we identify specific enabling conditions, reinforcing feedbacks, actors and interventions that can contribute to triggering positive tipping points in the adoption of sustainable behaviours and technologies. Actions that can create enabling conditions for positive tipping include targeting smaller populations, altering social network structure, providing relevant information, reducing price, improving performance, desirability and accessibility, and coordinating complementary technologies. Actions that can trigger positive tipping include social, technological and ecological innovations, policy interventions, public investment, private investment, broadcasting public information, and behavioural nudges. Positive tipping points can help counter widespread feelings of disempowerment in the face of global challenges and help unlock ‘paralysis by complexity’. A key research agenda is to consider how different agents and interventions can most effectively work together to create system-wide positive tipping points whilst ensuring a just transformation.
Social media summary
We identify key actors and actions that can enable and trigger positive tipping points towards global sustainability.
Studying phenotypic and genetic characteristics of age at onset (AAO) and polarity at onset (PAO) in bipolar disorder can provide new insights into disease pathology and facilitate the development of screening tools.
Aims
To examine the genetic architecture of AAO and PAO and their association with bipolar disorder disease characteristics.
Method
Genome-wide association studies (GWASs) and polygenic score (PGS) analyses of AAO (n = 12 977) and PAO (n = 6773) were conducted in patients with bipolar disorder from 34 cohorts and a replication sample (n = 2237). The association of onset with disease characteristics was investigated in two of these cohorts.
Results
Earlier AAO was associated with a higher probability of psychotic symptoms, suicidality, lower educational attainment, not living together and fewer episodes. Depressive onset correlated with suicidality and manic onset correlated with delusions and manic episodes. Systematic differences in AAO between cohorts and continents of origin were observed. This was also reflected in single-nucleotide variant-based heritability estimates, with higher heritabilities for stricter onset definitions. Increased PGS for autism spectrum disorder (β = −0.34 years, s.e. = 0.08), major depression (β = −0.34 years, s.e. = 0.08), schizophrenia (β = −0.39 years, s.e. = 0.08), and educational attainment (β = −0.31 years, s.e. = 0.08) were associated with an earlier AAO. The AAO GWAS identified one significant locus, but this finding did not replicate. Neither GWAS nor PGS analyses yielded significant associations with PAO.
Conclusions
AAO and PAO are associated with indicators of bipolar disorder severity. Individuals with an earlier onset show an increased polygenic liability for a broad spectrum of psychiatric traits. Systematic differences in AAO across cohorts, continents and phenotype definitions introduce significant heterogeneity, affecting analyses.
The first demonstration of laser action in ruby was made in 1960 by T. H. Maiman of Hughes Research Laboratories, USA. Many laboratories worldwide began the search for lasers using different materials, operating at different wavelengths. In the UK, academia, industry and the central laboratories took up the challenge from the earliest days to develop these systems for a broad range of applications. This historical review looks at the contribution the UK has made to the advancement of the technology, the development of systems and components and their exploitation over the last 60 years.
In 1245, the English delegation to the First Council of Lyons protested to Pope Innocent IV against the provision of foreign clergy to ecclesiastical benefices in England. ‘So that the truth may become fully known to you’, their letter complained, ‘the Italians in England are taking sixty thousand marks a year and more’ – an impressive sum, if true. This document is preserved in the Chronica majora of Matthew Paris under an unequivocal title ‘Letter from all the English in complaint about the extortion of revenues by the Roman curia’ (‘Epistola universitatis Angliae pro gravaminibus reddituum extortorum per curiam Romanam’). Such invective should come as no surprise, for the famous Benedictine was no friend of the Roman Church. In composing his historical works, Matthew seized every opportunity to rail against what he saw as papal meddling in England. For 1252, his Chronica record that the income of foreign clergy had risen again, allegedly to seventy thousand marks; in contrast, the king's income was apparently not even a third of this. Matthew's chronicle is a catalogue of papal injustice, interference and intrusion in the affairs of the English Church. His writings have left the indelible impression that in the thirteenth-century ecclesia Anglicana, foreigners took all the best jobs, sent all the money out of the country and could not even speak English. Matthew's views have exerted a strong pull on the scholarship on provisions right up to the beginning of this century. In 1869, Frederic Madden sided with Matthew in criticising the ‘unceasing’ provision of ‘needy, ignorant, and worthless Italians’ to valuable English benefices. Similarly, in an essay from 1929, Hugh MacKenzie rounded on the ‘greedy … foreigners’, whose ‘inability to speak English’, in his view, jeopardised pastoral care. Most scholars no longer accept Matthew's prejudices at face value, but because his chronicles represent some of the foundation stones of medieval English and European history, his views remain extremely influential. In 2005 Christopher Harper-Bill argued that:
The chronicler's rhetorical outbursts against foreign exploitation of English benefices have been frequently discounted, but recent work has suggested that the situation may have been almost as serious as contemporary English critics claimed.
We performed a prospective study of 501 patients, regardless of symptoms, admitted to the hospital, to estimate the predictive value of a negative nasopharyngeal swab for severe acute respiratory coronavirus virus 2 (SARS-CoV-2). At a positivity rate of 10.2%, the estimated negative predictive value (NPV) was 97.2% and the NPV rose as prevalence decreased during the study.
To develop a pediatric research agenda focused on pediatric healthcare-associated infections and antimicrobial stewardship topics that will yield the highest impact on child health.
Participants:
The study included 26 geographically diverse adult and pediatric infectious diseases clinicians with expertise in healthcare-associated infection prevention and/or antimicrobial stewardship (topic identification and ranking of priorities), as well as members of the Division of Healthcare Quality and Promotion at the Centers for Disease Control and Prevention (topic identification).
Methods:
Using a modified Delphi approach, expert recommendations were generated through an iterative process for identifying pediatric research priorities in healthcare associated infection prevention and antimicrobial stewardship. The multistep, 7-month process included a literature review, interactive teleconferences, web-based surveys, and 2 in-person meetings.
Results:
A final list of 12 high-priority research topics were generated in the 2 domains. High-priority healthcare-associated infection topics included judicious testing for Clostridioides difficile infection, chlorhexidine (CHG) bathing, measuring and preventing hospital-onset bloodstream infection rates, surgical site infection prevention, surveillance and prevention of multidrug resistant gram-negative rod infections. Antimicrobial stewardship topics included β-lactam allergy de-labeling, judicious use of perioperative antibiotics, intravenous to oral conversion of antimicrobial therapy, developing a patient-level “harm index” for antibiotic exposure, and benchmarking and or peer comparison of antibiotic use for common inpatient conditions.
Conclusions:
We identified 6 healthcare-associated infection topics and 6 antimicrobial stewardship topics as potentially high-impact targets for pediatric research.
Social cognitive deficits can have many negative consequences, spanning social withdrawal to psychopathology. Prior work has shown that child maltreatment may associate with poorer social cognitive skills in later life. However, no studies have examined this association from early childhood into adolescence. Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC; n = 4,438), we examined the association between maltreatment (caregiver physical or emotional abuse; sexual or physical abuse), assessed repeatedly (every 1–3 years) from birth to age 9, and social cognitive skills at ages 7.5, 10.5, and 14 years. We evaluated the role of both the developmental timing (defined by age at exposure) and accumulation of maltreatment (defined as the number of occasions exposed) using a least angle regression variable selection procedure, followed by structural equation modeling. Among females, accumulation of maltreatment explained the most variation in social cognitive skills. For males, no significant associations were found. These findings underscore the importance of early intervention to minimize the accumulation of maltreatment and showcase the importance of prospective studies to understand the development of social cognition over time.
Turbulent fluxes make a substantial and growing contribution to the energy balance of ice surfaces globally, but are poorly constrained owing to challenges in estimating the aerodynamic roughness length (z0). Here, we used structure from motion (SfM) photogrammetry and terrestrial laser scanning (TLS) surveys to make plot-scale 2-D and 3-D microtopographic estimations of z0 and upscale these to map z0 across an ablating mountain glacier. At plot scales, we found spatial variability in z0 estimates of over two orders of magnitude with unpredictable z0 trajectories, even when classified into ice surface types. TLS-derived surface roughness exhibited strong relationships with plot-scale SfM z0 estimates. At the glacier scale, a consistent increase in z0 of ~0.1 mm d−1 was observed. Space-for-time substitution based on time since surface ice was exposed by snow melt confirmed this gradual increase in z0 over 60 d. These measurements permit us to propose a scale-dependent temporal z0 evolution model where unpredictable variability at the plot scale gives way to more predictable changes of z0 at the glacier scale. This model provides a critical step towards deriving spatially and temporally distributed representations of z0 that are currently lacking in the parameterisation of distributed glacier surface energy balance models.
The Murchison Widefield Array (MWA) has observed the entire southern sky (Declination,
$\delta< 30^{\circ}$
) at low radio frequencies, over the range 72–231MHz. These observations constitute the GaLactic and Extragalactic All-sky MWA (GLEAM) Survey, and we use the extragalactic catalogue (EGC) (Galactic latitude,
$|b| >10^{\circ}$
) to define the GLEAM 4-Jy (G4Jy) Sample. This is a complete sample of the ‘brightest’ radio sources (
$S_{\textrm{151\,MHz}}>4\,\text{Jy}$
), the majority of which are active galactic nuclei with powerful radio jets. Crucially, low-frequency observations allow the selection of such sources in an orientation-independent way (i.e. minimising the bias caused by Doppler boosting, inherent in high-frequency surveys). We then use higher-resolution radio images, and information at other wavelengths, to morphologically classify the brightest components in GLEAM. We also conduct cross-checks against the literature and perform internal matching, in order to improve sample completeness (which is estimated to be
$>95.5$
%). This results in a catalogue of 1863 sources, making the G4Jy Sample over 10 times larger than that of the revised Third Cambridge Catalogue of Radio Sources (3CRR;
$S_{\textrm{178\,MHz}}>10.9\,\text{Jy}$
). Of these G4Jy sources, 78 are resolved by the MWA (Phase-I) synthesised beam (
$\sim2$
arcmin at 200MHz), and we label 67% of the sample as ‘single’, 26% as ‘double’, 4% as ‘triple’, and 3% as having ‘complex’ morphology at
$\sim1\,\text{GHz}$
(45 arcsec resolution). We characterise the spectral behaviour of these objects in the radio and find that the median spectral index is
$\alpha=-0.740 \pm 0.012$
between 151 and 843MHz, and
$\alpha=-0.786 \pm 0.006$
between 151MHz and 1400MHz (assuming a power-law description,
$S_{\nu} \propto \nu^{\alpha}$
), compared to
$\alpha=-0.829 \pm 0.006$
within the GLEAM band. Alongside this, our value-added catalogue provides mid-infrared source associations (subject to 6” resolution at 3.4
$\mu$
m) for the radio emission, as identified through visual inspection and thorough checks against the literature. As such, the G4Jy Sample can be used as a reliable training set for cross-identification via machine-learning algorithms. We also estimate the angular size of the sources, based on their associated components at
$\sim1\,\text{GHz}$
, and perform a flux density comparison for 67 G4Jy sources that overlap with 3CRR. Analysis of multi-wavelength data, and spectral curvature between 72MHz and 20GHz, will be presented in subsequent papers, and details for accessing all G4Jy overlays are provided at https://github.com/svw26/G4Jy.
The entire southern sky (Declination,
$\delta< 30^{\circ}$
) has been observed using the Murchison Widefield Array (MWA), which provides radio imaging of
$\sim$
2 arcmin resolution at low frequencies (72–231 MHz). This is the GaLactic and Extragalactic All-sky MWA (GLEAM) Survey, and we have previously used a combination of visual inspection, cross-checks against the literature, and internal matching to identify the ‘brightest’ radio-sources (
$S_{\mathrm{151\,MHz}}>4$
Jy) in the extragalactic catalogue (Galactic latitude,
$|b| >10^{\circ}$
). We refer to these 1 863 sources as the GLEAM 4-Jy (G4Jy) Sample, and use radio images (of
${\leq}45$
arcsec resolution), and multi-wavelength information, to assess their morphology and identify the galaxy that is hosting the radio emission (where appropriate). Details of how to access all of the overlays used for this work are available at https://github.com/svw26/G4Jy. Alongside this we conduct further checks against the literature, which we document here for individual sources. Whilst the vast majority of the G4Jy Sample are active galactic nuclei with powerful radio-jets, we highlight that it also contains a nebula, two nearby, star-forming galaxies, a cluster relic, and a cluster halo. There are also three extended sources for which we are unable to infer the mechanism that gives rise to the low-frequency emission. In the G4Jy catalogue we provide mid-infrared identifications for 86% of the sources, and flag the remainder as: having an uncertain identification (129 sources), having a faint/uncharacterised mid-infrared host (126 sources), or it being inappropriate to specify a host (2 sources). For the subset of 129 sources, there is ambiguity concerning candidate host-galaxies, and this includes four sources (B0424–728, B0703–451, 3C 198, and 3C 403.1) where we question the existing identification.
The letters of the First Crusade have traditionally been read as authentic and trustworthy eyewitness accounts of the expedition and they contribute greatly to scholarly understanding of the campaign. But new research on them demonstrates that many of the documents are in fact twelfth-century confections produced in the monastic communities of the West as a means of supporting, participating in and engaging with the crusading movement. This article develops new approaches to the letters and new research questions which account for and accept the problematic authenticity of the corpus, pivoting away from traditional methodologies to explore the monastic scribal cultures that produced and consumed First Crusade letters.
The science of studying diamond inclusions for understanding Earth history has developed significantly over the past decades, with new instrumentation and techniques applied to diamond sample archives revealing the stories contained within diamond inclusions. This chapter reviews what diamonds can tell us about the deep carbon cycle over the course of Earth’s history. It reviews how the geochemistry of diamonds and their inclusions inform us about the deep carbon cycle, the origin of the diamonds in Earth’s mantle, and the evolution of diamonds through time.
Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.
Methods
We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.
Results
16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (−0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).
Conclusions
PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
Where there are few jobs and many qualified applicants, there will be fierce competition. In the Middle Ages this manifested itself in the struggle for appointment to ecclesiastical benefices. Clerical candidates in want of a living fought bitterly against one another in order to acquire or defend possession of the fruits of churches throughout Christendom, and they employed an ingenious repertoire of legal strategies, tricks and deceptions in order to achieve their ends. The invention of papal provision in the twelfth century, and its widespread use throughout the West in the thirteenth century, was a disrupting influence which changed the face of this competition. Whereas candidates on the make had previously sought collation to Church positions through their local bishop, lay patron or the crown, from the thirteenth century they had a direct route to benefices through the papacy, which issued provision mandates to qualified clergy ordering their appointment to a suitable stipend. Papal provision brought with it advantages and disadvantages to the English clergy. It introduced one new method of appointment that levelled the playing field for those clerics who lacked the backing of a powerful prelate or lay patron, but it also brought with it new, Italian competitors for English benefices without increasing the number of such church livings available. Thus it intensified competition for benefices and also led to Italian immigration and the alienation of wealth from the English Church, which contemporaries such as Matthew Paris deplored. Modern scholars, following Matthew Paris, have tended to adopt a dim view of the papacy's intervention in the allocation of benefices across the face of the West, portraying it as an abuse of papal authority to intrude Italian favourites into far-away benefices. A more sensitive reading of the sources, however, reveals that papal intervention in the localities was far more complex than simple exploitation, and that the key period of expansion of the system in the thirteenth century was driven by native petitioners as well as papal kinsmen. The topic demands more detailed research if we hope to understand better this central aspect of the medieval Church. The present chapter goes some way towards this by exploring how petitioners made use of the papal supplicatory system as part of legal strategies to secure ecclesiastical benefices in thirteenth-century England, as well as how the papacy responded.
In 2009 Mark Ormrod, Gwilym Dodd and Anthony Musson broke new ground in the study of supplications in the Middle Ages with their edited volume Medieval Petitions: Grace and Grievance. Inspired by the completion of an AHRC-funded project to catalogue, digitise and study the SC 8 series of ‘Ancient Petitions’ preserved in The National Archives at Kew, Medieval Petitions tapped a rich vein of scholarship on supplications in medieval England and at the papal curia and helped to open up a field of study that has continued to flourish in the following decade. Broadly, there exist two strong traditions of research on petitions to the English crown, on the one hand, and ecclesiastical, specifically papal, petitions, on the other. Since 2009 a number of works have pushed the field in new directions. New research on petitions to the crown has illuminated aspects of petitioning such as supplications for royal pardon, women's petitions, multiple-clause petitions, petitions of complaint, the language of petitioning and the drafting process, as well as more general aspects of the processes and mechanisms of petitioning. These interpretative studies have also been supplemented by the publication of new documents in the form of the early common petitions presented to the English parliament. In the separate scholarly tradition on ecclesiastical supplications, new work has explored petitions regarding marriage, petitions for papal trade licences, the impact of petitioning on papal crusade diplomacy, the roles of proctors and more general aspects of petitioning. A particularly fruitful avenue of research explores supplications to the papal penitentiary, which is illuminating many new aspects of medieval life and the Church. The publication of new documents has also expanded the source base for this strand in the form of late medieval petitions to the penitentiary, as well as papal supplications from the University of Paris.
Despite common themes and the rich comparative possibilities, however, these two scholarly traditions have often remained separate, primarily because the Church and the crown had their own discrete – and extremely complex – systems of petitioning. Recently, however, a number of scholars have pioneered approaches that traverse the boundaries in the attempt to combine the two strands. Through her work on the fourteenth-century Roman Rolls in The National Archives, Barbara Bombi is pointing the way in the study of the interface between royal and papal supplicatory systems.