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Depression is a common mental health disorder that often starts during adolescence, with potentially important future consequences including ‘Not in Education, Employment or Training’ (NEET) status.
Methods
We took a structured life course modeling approach to examine how depressive symptoms during adolescence might be associated with later NEET status, using a high-quality longitudinal data resource. We considered four plausible life course models: (1) an early adolescent sensitive period model where depressive symptoms in early adolescence are more associated with later NEET status relative to exposure at other stages; (2) a mid adolescent sensitive period model where depressive symptoms during the transition from compulsory education to adult life might be more deleterious regarding NEET status; (3) a late adolescent sensitive period model, meaning that depressive symptoms around the time when most adults have completed their education and started their careers are the most strongly associated with NEET status; and (4) an accumulation of risk model which highlights the importance of chronicity of symptoms.
Results
Our analysis sample included participants with full information on NEET status (N = 3951), and the results supported the accumulation of risk model, showing that the odds of NEET increase by 1.015 (95% CI 1.012–1.019) for an increase of 1 unit in depression at any age between 11 and 24 years.
Conclusions
Given the adverse implications of NEET status, our results emphasize the importance of supporting mental health during adolescence and early adulthood, as well as considering specific needs of young people with re-occurring depressed mood.
Municipal and state governments are often constitutionally bound to ask voters to approve new government debt through voting on bond referendums. Generally, politicians expect voters to balk at higher-cost bonds and be more willing to approve lower-cost bonds. However, there is minimal research on how the amount of a bond affects voter support. We implement a survey experiment that presents respondents with hypothetical ballots, in which the cost of proposed bonds, the number of bonds on the ballot, and the order in which they are presented, are all randomized. Our results suggest that support is not responsive to the amount of the bond, even when the cost is well outside what is typical and within the bounds of what the government can afford. In contrast, we find other aspects of the ballot matter significantly more for bond referendum approval. The more bonds on the ballot and being placed lower on the ballot both reduce support significantly.
Icebergs in proglacial fjords serve as pupping, resting and molting habitat for some of the largest seasonal aggregations of harbor seals (Phoca vitulina richardii) in Alaska. One of the largest aggregations in Southeast Alaska occurs in Johns Hopkins Inlet, Glacier Bay National Park, where up to 2000 seals use icebergs produced by Johns Hopkins Glacier. Like other advancing tidewater glaciers, the advance of Johns Hopkins Glacier over the past century has been facilitated by the growth and continual redistribution of a submarine end moraine, which has limited mass losses from iceberg calving and submarine melting and enabled glacier thickening by providing flow resistance. A 15-year record of aerial surveys reveals (i) a decline in iceberg concentrations concurrent with moraine growth and (ii) that the iceberg size distributions can be approximated as power law distributions, with relatively little variability and no clear trends in the power law exponent despite large changes in ice fluxes over seasonal and interannual timescales. Together, these observations suggest that sustained tidewater glacier advance should typically be associated with reductions in the number of large, habitable icebergs, which may have implications for harbor seals relying on iceberg habitat for critical life-history events.
White kidney bean extract (WKBE) is a nutraceutical often advocated as an anti-obesity agent. The main proposed mechanism for these effects is alpha-amylase inhibition, thereby slowing carbohydrate digestion and absorption. Thus, it is possible that WKBE could impact the gut microbiota and modulate gut health. We investigated the effects of supplementing 20 healthy adults with WKBE for 1 week in a randomised, placebo-controlled crossover trial on the composition of the gut microbiota, gastrointestinal (GI) inflammation (faecal calprotectin), GI symptoms, and stool habits. We conducted in vitro experiments and used a gut model system to explore potential inhibition of alpha-amylase. We gained qualitative insight into participant experiences of using WKBE via focus groups. WKBE supplementation decreased the relative abundance of Bacteroidetes and increased that of Firmicutes, however, there were no significant differences in post-intervention gut microbiota measurements between the WKBE and control. There were no significant effects on GI inflammation or symptoms related to constipation, or stool consistency or frequency. Our in vitro and gut model system analyses showed no effects of WKBE on alpha-amylase activity. Our findings suggest that WKBE may modulate the gut microbiota in healthy adults, however, the underlying mechanism is unlikely due to active site inhibition of alpha-amylase.
Posttraumatic stress symptoms (PTSS) are common following traumatic stress exposure (TSE). Identification of individuals with PTSS risk in the early aftermath of TSE is important to enable targeted administration of preventive interventions. In this study, we used baseline survey data from two prospective cohort studies to identify the most influential predictors of substantial PTSS.
Methods
Self-identifying black and white American women and men (n = 1546) presenting to one of 16 emergency departments (EDs) within 24 h of motor vehicle collision (MVC) TSE were enrolled. Individuals with substantial PTSS (⩾33, Impact of Events Scale – Revised) 6 months after MVC were identified via follow-up questionnaire. Sociodemographic, pain, general health, event, and psychological/cognitive characteristics were collected in the ED and used in prediction modeling. Ensemble learning methods and Monte Carlo cross-validation were used for feature selection and to determine prediction accuracy. External validation was performed on a hold-out sample (30% of total sample).
Results
Twenty-five percent (n = 394) of individuals reported PTSS 6 months following MVC. Regularized linear regression was the top performing learning method. The top 30 factors together showed good reliability in predicting PTSS in the external sample (Area under the curve = 0.79 ± 0.002). Top predictors included acute pain severity, recovery expectations, socioeconomic status, self-reported race, and psychological symptoms.
Conclusions
These analyses add to a growing literature indicating that influential predictors of PTSS can be identified and risk for future PTSS estimated from characteristics easily available/assessable at the time of ED presentation following TSE.
A successful career in a surgical specialty is both rewarding and challenging. In order to perform safely and effectively in this role, the operator requires a good combination of technical skills, intellectual ability and appropriate personal qualities.
Complete an audit of Section 2 and Section 3 Mental Health Act Paperwork in Derby Inpatient psychiatric units using an audit tool developed in a study by Mason et al. (2012).
Background
The 1983 Mental Health Act enables doctors approved on behalf of the Secretary of State under Section 12 to be able to make recommendations for the detention of individuals with a mental health problem where the degree and/or nature, and associated risk to that person's health or safety, or that of others, makes inpatient care necessary. For the detention and the associated deprivation of their liberty to be lawful, it is necessary that the clinical situation meets certain criteria as outlined in the Mental Health Act.
Method
Ward status was reviewed for each inpatient ward in Derby and the first five patients alphabetically, who were detained under sections 2 or 3 were selected. The Mental Health Act medical recommendation documents were reviewed according to the necessary criteria, using an assessment tool generated from a study by Mason et al. in 2012 ‘Compulsion under the Mental Health Act 1983: audit of the quality of medical recommendations’. A junior colleague was trained to analyse Mental Health Act paperwork using the audit tool. Medical recommendations were reviewed and rated as ‘clear’, ‘implied’ or ‘none’ for each criterion.
Result
Evidence of a mental health problem and the nature or degree of illness was well documented. Evidence regarding why informal admission was not appropriate was also reasonable but with room for improvement. Poor compliance was evident mostly in relation to the justification related to risk to health, safety or others, the lowest clearly documented percentage of these appear to be regarding health.
Conclusion
From analysing the documentation, often written justification incorporated general safety as a whole; however health and safety are identified by the mental health act as separate criterion requiring clear justification of each. In a number of occasions people failed to identify which of the three risk categories were relevant for the patient. Potential criticisms of this audit include the subjective nature of the interpretation of clearly explained and implied and that data analysis was completed by a non-section 12 approved doctor. Data were presented at the local weekly academic teaching to raise awareness of the results and a recommendation was made for the subject to be included in the junior doctor induction.
Exercise is associated with higher cognitive function and is a promising intervention to reduce the risk of dementia. With advancing age, there are changes in the vasculature that have important clinical implications for brain health and cognition. Primary aging and vascular risk factors are associated with increases in arterial stiffness and pulse pressure, and reductions in peripheral vascular function.
Objective:
The purpose is to discuss the epidemiological, observational, and mechanistic evidence regarding the link between age-related changes in vascular health and brain health.
Methods:
We performed a literature review and integrated with our published data.
Results:
Epidemiological evidence suggests a link between age-related increases in arterial stiffness and lower cognitive function, which may be mediated by cerebral vascular function, including cerebral vasoreactivity and cerebral pulsatility. Age-associated impairments in central arterial stiffness and peripheral vascular function have been attenuated or reversed through lifestyle behaviors such as exercise. Greater volumes of habitual exercise and higher cardiorespiratory fitness are associated with beneficial effects on both peripheral vascular health and cognition. Yet, the extent to which exercise directly influences cerebral vascular function and brain health, as well as the associated mechanisms remains unclear.
Conclusion:
Although there is evidence that exercise positively impacts cerebral vascular function, more research is necessary in humans to optimize experimental protocols and address methodological limitations and physiological considerations. Understanding the impact of exercise on cerebral vascular function is important for understanding the association between exercise and brain health and may inform future intervention studies that seek to improve cognition.
The authors of this article consider the relationship in European prehistory between the procurement of high-quality stones (for axeheads, daggers, and other tools) on the one hand, and the early mining, crafting, and deposition of copper on the other. The data consist of radiocarbon dates for the exploitation of stone quarries, flint mines, and copper mines, and of information regarding the frequency through time of jade axeheads and copper artefacts. By adopting a broad perspective, spanning much of central-western Europe from 5500 to 2000 bc, they identify a general pattern in which the circulation of the first copper artefacts was associated with a decline in specialized stone quarrying. The latter re-emerged in certain regions when copper use decreased, before declining more permanently in the Bell Beaker phase, once copper became more generally available. Regional variations reflect the degrees of connectivity among overlapping copper exchange networks. The patterns revealed are in keeping with previous understandings, refine them through quantification and demonstrate their cyclical nature, with additional reference to likely local demographic trajectories.
The COVID-19 pandemic and mitigation measures are likely to have a marked effect on mental health. It is important to use longitudinal data to improve inferences.
Aims
To quantify the prevalence of depression, anxiety and mental well-being before and during the COVID-19 pandemic. Also, to identify groups at risk of depression and/or anxiety during the pandemic.
Method
Data were from the Avon Longitudinal Study of Parents and Children (ALSPAC) index generation (n = 2850, mean age 28 years) and parent generation (n = 3720, mean age 59 years), and Generation Scotland (n = 4233, mean age 59 years). Depression was measured with the Short Mood and Feelings Questionnaire in ALSPAC and the Patient Health Questionnaire-9 in Generation Scotland. Anxiety and mental well-being were measured with the Generalised Anxiety Disorder Assessment-7 and the Short Warwick Edinburgh Mental Wellbeing Scale.
Results
Depression during the pandemic was similar to pre-pandemic levels in the ALSPAC index generation, but those experiencing anxiety had almost doubled, at 24% (95% CI 23–26%) compared with a pre-pandemic level of 13% (95% CI 12–14%). In both studies, anxiety and depression during the pandemic was greater in younger members, women, those with pre-existing mental/physical health conditions and individuals in socioeconomic adversity, even when controlling for pre-pandemic anxiety and depression.
Conclusions
These results provide evidence for increased anxiety in young people that is coincident with the pandemic. Specific groups are at elevated risk of depression and anxiety during the COVID-19 pandemic. This is important for planning current mental health provisions and for long-term impact beyond this pandemic.
Between 1840 and the collapse of the Atlantic slave trade in the 1860s, the tiny island of St. Helena served as a major trial venue and receiving depot for slave ships captured by the Royal Navy's West Africa Squadron. In all, some twenty-four thousand people were legally freed by St. Helena's vice-admiralty court, though ongoing mortality within the receiving “depots” meant that fewer than eighteen thousand actually survived the slave ship and its immediate aftermath.1 St. Helena is extremely remote: set in the mid-Atlantic its nearest continental landfall is Angola, just over 1,800 kilometers to the east, with the Brazilian coast 3,260 kilometers distant to the west. It is also tiny: 17 kilometers long and 10 kilometers wide, it occupies an area of only 122 square kilometers.
The remoteness of St. Helena, while causing significant logistical problems in respect to its antislavery role, did not set it apart from other British possessions where liberated Africans were received. Indeed, the island's position in relation to trade winds and ocean currents, and its vital role as a staging post on the Atlantic voyage back from India, made it far better connected than many of its antislavery counterparts. Both Sierra Leone and Liberia, though critical centers for abolition, were peripheral to mainstream global networks, while places such as Gambia and Luanda were truly remote. Thus, despite its mid-Atlantic placement, St. Helena should be seen in the same context as other major maritime hubs, including Cape Town and Rio de Janeiro. It was, instead, the fact of it being an island, and an extremely small one at that, that made St. Helena different. Other places could absorb significant numbers of the liberated Africans they received into their expanding hinterlands, Cape Colony and Sierra Leone being prominent examples, but St. Helena was unable to do so. Self-evidently it had finite territory, while its population level was already close to the maximum number supportable. Moreover, its economy was based entirely on servicing passing maritime traffic, but by the 1840s this trade was beginning to decline, causing not only economic hardship but also undermining the colony's entire raison d’être.
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.
New radiocarbon (14C) dates suggest a simultaneous appearance of two technologically and geographically distinct axe production practices in Neolithic Britain; igneous open-air quarries in Great Langdale, Cumbria, and from flint mines in southern England at ~4000–3700 cal BC. In light of the recent evidence that farming was introduced at this time by large-scale immigration from northwest Europe, and that expansion within Britain was extremely rapid, we argue that this synchronicity supports this speed of colonization and reflects a knowledge of complex extraction processes and associated exchange networks already possessed by the immigrant groups; long-range connections developed as colonization rapidly expanded. Although we can model the start of these new extraction activities, it remains difficult to estimate how long significant production activity lasted at these key sites given the nature of the record from which samples could be obtained.
Optimising short- and long-term outcomes for children and patients with CHD depends on continued scientific discovery and translation to clinical improvements in a coordinated effort by multiple stakeholders. Several challenges remain for clinicians, researchers, administrators, patients, and families seeking continuous scientific and clinical advancements in the field. We describe a new integrated research and improvement network – Cardiac Networks United – that seeks to build upon the experience and success achieved to-date to create a new infrastructure for research and quality improvement that will serve the needs of the paediatric and congenital heart community in the future. Existing gaps in data integration and barriers to improvement are described, along with the mission and vision, organisational structure, and early objectives of Cardiac Networks United. Finally, representatives of key stakeholder groups – heart centre executives, research leaders, learning health system experts, and parent advocates – offer their perspectives on the need for this new collaborative effort.
This book is an examination of the island of St Helena’s involvement in slave trade abolition. After the establishment of a British Vice-Admiralty court there in 1840, this tiny and remote South Atlantic colony became the hub of naval activity in the region. It served as a base for the Royal Navy’s West Africa Squadron, and as such became the principal receiving depot for intercepted slave ships and their human cargo. During the middle decades of the nineteenth century over 25,000 ‘recaptive’ or ‘liberated’ Africans were landed at the island. Here, in embryonic refugee camps, these former slaves lived and died, genuine freedom still a distant prospect.
This book provides an account and evaluation of this episode. It begins by charting the political contexts which drew St Helena into the fray of abolition, and considers how its involvement, at times, came to occupy those at the highest levels of British politics. In the main, however, it focuses on St Helena itself, and examines how matters played out on the ground. The study utilises documentary sources (many previously untouched) which tell the stories of those whose lives became bound up in the compass of anti-slavery, far from London and long after the Abolition Act of 1807. It puts the Black experience at the foreground, aiming to bring a voice to a forgotten people, many of whom died in limbo, in a place that was physically and conceptually between freedom and slavery.
The research and development of novel photovoltaic technologies is going through a golden era, thanks to the demonstration of remarkable efficiencies across a broad range of semiconductor classes and device architectures. In parallel with these developments, the opportunities for characterizing the structure of a semiconductor film in situ of a processing step have also increased, to the extent that in situ and in operando experiments are becoming readily accessible to researchers. These combined advances represent the subject matter of this article, wherein studies that improve our understanding of structure formation and evolution in perovskite and organic semiconductor films for innovative solar cells are reviewed. Although focus is placed on the dynamics of semiconductor film formation, the review also highlights recent research on environmental testing, a key component in the development of materials with high intrinsic stability.
Multiple isotopic systems (C, N, O, S, Sr, Pb) are applied to investigate diet and mobility amongst the Middle Neolithic populations at Schipluiden and Swifterbant (Netherlands). A review of carbon and nitrogen isotope analyses of European Mesolithic and Neolithic populations shows a shift in diet from the Mesolithic to the Neolithic, but also great variety in Neolithic diets, several of which incorporate fish. At Swifterbant (c. 4300–4000 BC) the population had a diet largely based on terrestrial and freshwater resources, despite proximity to tidal waters. Only one individual (of 10) showed evidence for migration. In contrast at Schipluiden (c. 3600–3400 BC) there were migrants who had a diet lower in marine resources than those without evidence for migration. The faunal spectrum and isotopic similarities with sites in the Iron Gates Gorge suggest that sturgeon may have been important. There is some evidence that migrants at Schipluiden were not accorded the formal burial given to locally born people.
Photovoltaics made from organic–inorganic hybrid perovskite semiconductors are attracting significant interest due to their ability to harvest sunlight with remarkable efficiency. The presence of lead in the best performing devices raises concerns regarding their toxicity, a problem that may create barriers to commercialization. Hybrid perovskites with reduced lead content are being investigated to overcome this issue and here we evaluate bismuth as a possible lead substitute. For a series of hybrid perovskite films with the general composition CH3NH3(PbyBi1−y)I3−xClx, we characterize their optical and structural properties using UV–Vis spectroscopy, scanning electron microscopy and grazing incidence wide angle X-ray scattering. We show that they form crystalline structures with an optical band gap, around 2 eV for CH3NH3BiI3. However, preliminary solar cell tests show low power conversion efficiencies (<0.01%) due to both incomplete precursor conversion and material de-wetting from the substrate. The overall outcome is severely limited photocurrent. With current processing methods the general applicability of hybrid bismuth perovskites in photovoltaics may be limited.