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Childhood maltreatment can lead to poor socioemotional development, which may undermine parental functioning in adulthood. Having a large social network of relatives and friends, however, might buffer the effects of childhood maltreatment on parents. This prediction was examined using prospective data from the Minnesota Longitudinal Study of Risk Adaptation (N = 173). Early childhood maltreatment was assessed prospectively at ages 0 – 5. Socioemotional competence during middle childhood and adolescence (ages 5 – 16) was assessed via teacher reports. Adult parenting was assessed using a semi-structured interview at age 32 (N = 106) and dyadic parent-child observations at various ages (N = 85). At age 32, participants also wrote the names of friends and relatives in their inner, middle, and outer social circles. In a moderated mediation analysis, childhood maltreatment forecasted low socioemotional competence, which in turn predicted more negative parental orientations (greater hostility and lower emotional connectedness and involvement) and lower observed parental support in adulthood. However, having a large social network and having friends in one’s inner circle buffered this effect. These results highlight the significance of social networks in supporting parents who were maltreated in childhood, and primarily the importance of close friends.
The stars of the Milky Way carry the chemical history of our Galaxy in their atmospheres as they journey through its vast expanse. Like barcodes, we can extract the chemical fingerprints of stars from high-resolution spectroscopy. The fourth data release (DR4) of the Galactic Archaeology with HERMES (GALAH) Survey, based on a decade of observations, provides the chemical abundances of up to 32 elements for 917 588 stars that also have exquisite astrometric data from the Gaia satellite. For the first time, these elements include life-essential nitrogen to complement carbon, and oxygen as well as more measurements of rare-earth elements critical to modern-life electronics, offering unparalleled insights into the chemical composition of the Milky Way. For this release, we use neural networks to simultaneously fit stellar parameters and abundances across the whole wavelength range, leveraging synthetic grids computed with Spectroscopy Made Easy. These grids account for atomic line formation in non-local thermodynamic equilibrium for 14 elements. In a two-iteration process, we first fit stellar labels to all 1 085 520 spectra, then co-add repeated observations and refine these labels using astrometric data from Gaia and 2MASS photometry, improving the accuracy and precision of stellar parameters and abundances. Our validation thoroughly assesses the reliability of spectroscopic measurements and highlights key caveats. GALAH DR4 represents yet another milestone in Galactic archaeology, combining detailed chemical compositions from multiple nucleosynthetic channels with kinematic information and age estimates. The resulting dataset, covering nearly a million stars, opens new avenues for understanding not only the chemical and dynamical history of the Milky Way but also the broader questions of the origin of elements and the evolution of planets, stars, and galaxies.
There has been a proliferation of ultra-processed foods (UPF) in the food environment since the 1980s which have newly been linked to growing number of non-communicable diseases (NCD) including cardiovascular disease, cancers, type 2 diabetes, fatty liver disease, depression, frailty, and hypertension(1). There is intense debate surrounding whether the mechanism for the negative effect on health of consumption of UPF is their nutrition composition or processing(1). There is growing evidence that macronutrient ratios are important for chronic disease risk, predict longevity and may adversely affect micronutrient intakes(2). Intake of macronutrients from ultra-processed sources may lead to macronutrient imbalances and higher energy intakes(3) while being deficient in micronutrients, making it difficult to achieve energy balance and meet micronutrient requirements. Using nationally representative nutrition surveillance data on the Australian population, the National Nutrition and Physical Activity Survey, in this paper we employ the Geometric Framework for Nutrition(2) to examine the multidimensional dietary composition of UPF. Diet was assessed for adults (n = 9.341) with two 24-hour recalls. Diets were classified by degree of processing according the NOVA classification system and classified as ultra-processed diets (UPD, > 60% energy from UPF), moderate or low in UPF i.e., minimally processed diets (MPD, < 20% energy from UPF). Outcomes included the nutrient rich food index (NRF 9.3 index)(4), the Nutri-Score(5), and macronutrient and micronutrient intakes. Micronutrients were plotted over macronutrient ratios for MPD and UPD to determine whether micronutrient intakes could be met within the acceptable macronutrient distribution ranges (AMDR). Scheffe’s polynomials were fitted to the data for total energy intake, macronutrient intake and micronutrient intake. Vitamin and mineral intakes were higher for MPD compared to UPD (p < 0.001). Overall nutrient density decreased and the NRF 9.3 scores were 399.2 for MPD and 297.7 for UPD (p < 0.001). For the Nutri-Score, MPD diets scored A (highest quality) and UPD scored C (moderate quality). Poor scores were due to higher energy density, saturated fat, added sugar and sodium increased with UPD, while protein, dietary fibre and micronutrient density and fruit, vegetable, nut and legume ratios decreased. Diets met the estimated average requirement (EAR) for all micronutrients within AMDR for MPD but not for UPD. Regardless of processing, in almost all nutritional indicators of health, diets high in UPF were unsatisfactory relative to nutritional recommendations. We conclude that compositional factors alone point to the mechanisms through which ultra-processed dietary patterns could lead to poor health, in the full understanding that processing likely has additional effects over and above composition that exacerbates the problem.
Fatigue is a prevalent symptom in people with multiple sclerosis (MS), significantly impacting quality of life and daily functioning(1). The Mediterranean diet, with its anti-inflammatory and neuroprotective properties, may help to alleviate fatigue(2). However, existing evidence linking the Mediterranean diet to fatigue in people with MS is primarily cross-sectional, providing limited insights into long-term effects(3). This study aimed to prospectively test associations between the alternate Mediterranean diet score (aMED) and fatigue using data from the United Kingdom (UK) Multiple Sclerosis Register. Dietary intake was measured in 2016 (n = 2,455) and 2022 (n = 3,740) using the EPIC-Norfolk 130-item Food Frequency Questionnaire. A total of 879 participants provided dietary intake data at both timepoints. aMED is a score ranging from 0 to 9, with higher scores indicating greater adherence to a Mediterranean diet (higher consumption of vegetables, fruit, nuts, legumes, whole-grains, fish; greater monounsaturated-to-saturated fat ratio; lower consumption of red meat; moderate consumption of alcohol). Fatigue was measured using the Fatigue Severity Scale (FSS), a 9-item questionnaire that evaluates the extent to which fatigue interferes with daily activities, with scores ranging from 1 to 7. Additionally, fatigue levels were categorised as either ‘high’ (FSS score: ≥ 5) or ‘low’ (FSS score: < 5). The association between aMED and fatigue over six years (from 2016 to 2022) was assessed using generalized mixed-effects models for the continuous FSS score, while mixed-effects logistic regression models were employed to examine the association between aMED and binary FSS categories (high/low). The models were adjusted for age, sex, MS type (benign, relapse-remitting, secondary progressive, primary progressive, unknown), and total energy intake (kcal/day). Analysis was restricted to those participating at both timepoints and who had complete data on diet, covariates, and FSS (n = 379). The study population consisted of 71.5% females, with a mean age of 55.0 years (standard deviation, 9.9). Higher aMED scores (one-unit increase) were significantly associated with lower FSS scores (adjusted β = -0.08; 95% CI: -0.14, -0.03; p = 0.004) and with 17% lower odds of having high fatigue (FSS > 5), with an adjusted odds ratio of 0.83 (95% CI: 0.71, 0.98; p = 0.029). These findings suggest that adherence to a Mediterranean diet may play a protective role in reducing fatigue severity in people with MS over a 6-year period. Further research could explore associations between a Mediterranean diet and other MS related outcomes in this study population.
Neil Levy’s book Bad Beliefs defends a prima facie attractive approach to social epistemic policy – namely, an environmental approach, which prioritises the curation of a truth-conducive information environment above the inculcation of individual criti cal thinking abilities and epistemic virtues. However, Levy’s defence of this approach is grounded in a surprising and provocative claim about the rationality of deference. His claim is that it’s rational for people to unquestioningly defer to putative authorities, because these authorities hold expert status. As friends of the environmental approach, we try to show why it will be better for that approach to not be argumentatively grounded in this revisionist claim about when and why deference is rational. We identify both theoretical and practical problems that this claim gives rise to.
Objectives/Goals: The Wake Forest Clinical and Translational Science Institute (CTSI) has integrated academic goals of T0-T4 translation, scholarship, and education into our Academic Learning Health System (aLHS) framework. Our Translation Research Academy (TRA) provides rigorous training for outstanding and diverse K12 and early-career faculty to develop LHS core competencies. Methods/Study Population: The TRA Forum is the main vehicle for delivering an aLHS-oriented curriculum. Currently, the program includes six K12 scholars and 18 other early-career research faculty with facilitated access to CTSI resources. The TRA Forum is a 2-year seminar series that meets twice a month to discuss topics relevant to the aLHS, leadership, and career development. Inclusion of first- and second-year scholars facilitates peer mentorship, allowing Year 2 scholars to share insights with new scholars. Forum sessions are developed around adult learning theory: Each participant is asked to contribute their experience to discussions, and sessions focus on real-world examples. Results/Anticipated Results: Scholar and faculty commitment is very high. For the first 30 min., scholars present their work in small groups. This extends the range of disciplines exposed (64% of TRA graduates found this very helpful) and promotes translational traits of boundary crosser, team player, and systems thinker. Participants view the TRA as an opportunity to form internal peer networks, promote peer mentoring, and establish new collaborations. The remaining 60 minutes are used for education. Sessions include nominated topics and those providing a solid foundation in core aLHS competencies and characteristics of translational scientists. Educational sessions (97%) were rated as helpful or very helpful. Discussion/Significance of Impact: TRA scholars receive rigorous training in a highly supportive environment to produce aLHS researchers with skills to transcend boundaries, innovate systems, create new knowledge, and rigorously evaluate results.
Non-traumatic back pain commonly leads people to seek health care from paramedics via triple-zero (emergency phone number in Australia), yet the management approaches by providers of ambulance services remain unclear.
Study Objectives:
This study aims to investigate paramedic management of non-traumatic back pain in New South Wales (NSW), Australia, including the call characteristics, provisional diagnoses, and the clinical care being delivered by paramedics.
Methods:
This study is a retrospective analysis of NSW Ambulance computer-aided dispatch and electronic medical records from January 1, 2017 through December 31, 2022. Adults who sought ambulance service with a chief complaint of back pain, were triaged as non-traumatic back pain, and subsequently received treatment by paramedics were included. Multivariable logistic regression models were used to explore factors associated with primary outcomes; ambulance transport, opioid use, and use of medication combinations were reported as odds ratios (ORs).
Results:
There were 73,128 calls to NSW Ambulance with a chief complaint of back pain that were triaged as non-traumatic back pain. Of these, 54,444 (74.4%) were diagnosed with spinal pain, of which 52,825 (97.1%) were categorized by the paramedic as back or neck pain, 1,573 (2.9%) as lumbar radicular pain, and 46 (0.1%) as serious spinal pathology. Eight out of ten patients with spinal pain were transported to emergency departments. The medicine most administered by a paramedic was an opioid (37.4% of patients with spinal pain). Older patients (OR = 1.36; 95% CI, 1.30 to 1.44) were more likely to be transported to an emergency department. Patients with moderate (OR = 4.39; 95% CI, 4.00 to 4.84) and severe pain (OR = 18.90; 95% CI, 17.18 to 20.79) were more likely to be administered an opioid.
Conclusions:
Paramedic management of non-traumatic back pain in NSW typically results in the administration of an opioid and transport to an emergency department.
Advance Choice Documents (ACDs) have been recommended for inclusion in new mental health legislation for England and Wales based on evidence they reduce compulsory psychiatric admission, with particular benefit for Black people. As Black people disproportionately experience compulsory psychiatric admission in the UK, our aim was to explore potential barriers and enablers to effective ACD implementation for Black people with previous experience of compulsory admission.
Methods:
Six stakeholder workshops and one consensus workshop were held with: Black service users who had previously been involuntarily admitted, carers/supporters of Black service users, and mental health staff. Thematic analysis was conducted on workshop transcripts.
Results:
Participants were service users (n = 13), carers/supporters (n = 7), service users and carers/supporters (n = 3), and staff (n = 18). Thematic analysis identified themes of ‘training’, ‘completion’, ‘access’, and ‘use’ concerning ACD implementation. Stakeholders highlighted the importance of understanding the racialised experience of Black service users for effective ACD implementation. Strong communication between and amongst stakeholders and helpful systems for access were also emphasised. Stakeholders also recommended joint training and independent facilitation of ACDs to address Black service user-staff power imbalances.
Conclusions:
Known enablers and barriers to ACD implementation are important when considering ACDs for Black people, as is explicitly engaging with their experiences holistically, including racialised historical and individual experiences that underline some treatment preferences. Independent facilitation and shifts in service user-staff power dynamics present as key to realising the potential of ACDs to empower Black service users in relation to their care, and in turn to potentially reduce coercive care.
Preliminary evidence suggests that a ketogenic diet may be effective for bipolar disorder.
Aims
To assess the impact of a ketogenic diet in bipolar disorder on clinical, metabolic and magnetic resonance spectroscopy outcomes.
Method
Euthymic individuals with bipolar disorder (N = 27) were recruited to a 6- to 8-week single-arm open pilot study of a modified ketogenic diet. Clinical, metabolic and MRS measures were assessed before and after the intervention.
Results
Of 27 recruited participants, 26 began and 20 completed the ketogenic diet. For participants completing the intervention, mean body weight fell by 4.2 kg (P < 0.001), mean body mass index fell by 1.5 kg/m2 (P < 0.001) and mean systolic blood pressure fell by 7.4 mmHg (P < 0.041). The euthymic participants had average baseline and follow-up assessments consistent with them being in the euthymic range with no statistically significant changes in Affective Lability Scale-18, Beck Depression Inventory and Young Mania Rating Scale. In participants providing reliable daily ecological momentary assessment data (n = 14), there was a positive correlation between daily ketone levels and self-rated mood (r = 0.21, P < 0.001) and energy (r = 0.19 P < 0.001), and an inverse correlation between ketone levels and both impulsivity (r = −0.30, P < 0.001) and anxiety (r = −0.19, P < 0.001). From the MRS measurements, brain glutamate plus glutamine concentration decreased by 11.6% in the anterior cingulate cortex (P = 0.025) and fell by 13.6% in the posterior cingulate cortex (P = <0.001).
Conclusions
These findings suggest that a ketogenic diet may be clinically useful in bipolar disorder, for both mental health and metabolic outcomes. Replication and randomised controlled trials are now warranted.
Through compositional inclusion or exclusion, the photograph can assert and communicate what belongs in a picture, in a landscape, in an ecosystem. It can illuminate what we deem conservation-worthy, or, on a larger scale, which extinctions are attention-worthy. Photographic practice helps to illuminate the active nature of extinction, and our choices as actors and witnesses within that process. Here, researchers from the University of Leeds’ Extinction Studies Doctoral Training Programme present individual reflections on interdisciplinary practice-led research in the Scottish Small Isles. We consider how photography, as a form of praxis, can generate new forms of knowledge surrounding extinction: its meanings, representations, and legacies, particularly through visual representation. We offer seven perspectives on contemporary image-making, from disciplines including philosophy, conservation biology, literature, sociology, geology, cultural anthropology, and palaeontology. Researchers gathered experiential, ethical, even biological meanings from considering what to include or exclude in images: from the micro to the macro, the visible to the invisible, the aesthetic to the ecological. We draw conclusions around meaning-making through the process of photography itself, and the tensions encountered through framing and decision-making in a time of mass ecological decline.
Bram Stoker’s Dracula (1897) offers the reader fantastical versions of two seemingly realistic office technologies: shorthand writing and polyglot dictionaries. In both cases, Stoker’s changes allow the reader to see varieties of spoken language in ways that the real technologies would not have allowed. Representing dialect through shorthand, as Mina Harker does, would have been impossible with Pitman shorthand as well as antithetical to the principles behind that writing system. And no books existed that could have enabled the translations that Jonathan Harker claims to make with his polyglot dictionary. However, Stoker uses standard English spelling when representing characters of higher status, such as Van Helsing, Morris, and Dracula, all of whom represent national types that were routinely marked by dialect respelling in other fictions of Stoker’s time. The novel therefore exhibits two contrary tendencies: Stoker uses nonstandard spelling when he could easily have avoided it, and he avoids it when he could easily have used it. We place that contradiction in Victorian debates about spelling reform and language purity. We argue that the novel uses standard spelling to reinforce an alliance of Anglo-Teutonic elites, whereas the heteroglossia and polyglossia of these language technologies undermine that trajectory.
The ‘free trade’ provision in Australia’s Constitution, section 92, remains partially uncharted territory, both as to its practical operation and its doctrinal underpinnings. Section 92 is presently understood as a non-discrimination norm. While interpretation has cleaved the norm into two distinct strands, this article addresses only one of those, that concerning protectionist discrimination against interstate trade or commerce. Although there are many outstanding issues regarding this norm’s operation in particular settings – for instance its operation upon the Commonwealth and its ramifications for export controls – I will not be exploring those frontiers here. Rather, my interest is in the established core of the protectionist discrimination principle and the soundness of its doctrinal underpinnings. I will focus in this article upon a crucial missing piece in our contemporary picture of section 92’s make up, specifically, the relationship between legislative purpose and practical effect in the identification of protectionist discrimination.
This Comment considers the High Court's recent decision in Sweedman v Transport Accident Commission. The issue dealt with at greatest length in the judgments was the suggested conflict between New South Wales and Victorian enactments and the related suggestion that constitutional principles would enliven to resolve this conflict. A second issue, the potential application of the s 117 prohibition on State residence discrimination, attracted less detailed treatment. Nevertheless, the Court's resolution of this second issue is significant in its apparent departure from the approach taken in the landmark case of Street v Queensland Bar Association. While this Comment will explain the Court's reasoning on both issues, analysis of the decision will focus on the s 117 issue.
On 5 October 2000, the High Court handed down its latest decision on the scope of s 80 of the Commonwealth Constitution. This note provides an overview of the decision and its importance, and offers a critique of the reasoning employed in the majority judgments.
Section 80, variously described but commonly referred to as the trial by jury provision, “has led to some of the sharpest divisions of opinion in the history of this Court”. Whilst the decision in Cheng v The Queen (hereafter Cheng) confirms the interpretation given to s 80 in Kingswell v The Queen—which involved a challenge to the same provisions of the Customs Act 1901 (Cth)—some of the judges making up the majority in Cheng admitted to reservations about that interpretation. In addition, Kirby J and Gaudron J were vociferous in their disagreement with much of the majority's reasoning, which suggests that fundamental differences over the meaning of s 80 will continue to plague the Court into the future.
In July 2022, a genetically linked and geographically dispersed cluster of 12 cases of Shiga toxin-producing Escherichia coli (STEC) O103:H2 was detected by the UK Health Security Agency using whole genome sequencing. Review of food history questionnaires identified cheese (particularly an unpasteurized brie-style cheese) and mixed salad leaves as potential vehicles. A case–control study was conducted to investigate exposure to these products. Case food history information was collected by telephone. Controls were recruited using a market research panel and self-completed an online questionnaire. Univariable and multivariable analyses were undertaken using Firth Logistic Regression. Eleven cases and 24 controls were included in the analysis. Consumption of the brie-style cheese of interest was associated with illness (OR 57.5, 95% confidence interval: 3.10–1,060). Concurrently, the production of the brie-style cheese was investigated. Microbiological sample results for the cheese products and implicated dairy herd did not identify the outbreak strain, but did identify the presence of stx genes and STEC, respectively. Together, epidemiological, microbiological, and environmental investigations provided evidence that the brie-style cheese was the vehicle for this outbreak. Production of unpasteurized dairy products was suspended by the business operator, and a review of practices was performed.
This book challenges Western-centric views on sex in later life by exploring diverse cultures from the majority world. It advocates learning from overlooked perspectives and dismantling stereotypes about their sexual conservatism. It critiques cultural binaries, emphasising the need to decentre Western perspectives as the benchmark.