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In their rich history, community-based educational spaces (CBESs) have afforded communities room to build young people’s critical consciousness, to organize for social change, and to create learning environments that foster a political – and, in certain respects, a more meaningful – education. Broadly speaking, CBESs meet the specific needs of communities, such as providing access to food and opportunities for learning and identity exploration. In this chapter, the authors overview the scholarly literature related to CBESs and their power-building features that facilitate community power and psychological empowerment processes, as well as the tensions in CBESs that can hinder power-building. Amid this discussion, the authors highlight Urban Underground, a CBES in Milwaukee, Wisconsin, as an organization that exemplifies the humanizing education, youth empowerment, and power-building possible within CBESs. Through this chapter, the authors contend that CBESs have the power to bring about social change in their communities and spur transformative change for those they serve.
Soil samples from 79 sites on five islands of Indonesia were baited with insects for the recovery of entomopathogenic nematodes. Heterorhabditis and Steinernema were equally prevalent, and were recovered from 11.7% of samples representing 20.3% of sites sampled. Both genera were recovered from coastal sites only. Entomopathogenic nematodes were more prevalent on the Moluccan islands of Ambon and Seram than on Java or Bali. They were not detected on Sulawesi, where non-coastal sites only were sampled. RFLP analysis was used in the identification of nematode isolates. Heterorhabditis indica was the only heterorhabditid identified. Two RFLP types ofSteinernema were identified.
Behavioural patterns are important in understanding the synergistic effect of multiple health behaviours on childhood adiposity. Most previous evidence assessing associations between patterns and adiposity were cross-sectional and investigated two or three behaviour domains within patterns. This study aimed to identify behavioural patterns comprising four behaviour domains and investigate associations with adiposity risk in children.
Design:
Parent-report and accelerometry data were used to capture daily dietary, physical activity, sedentary behaviour and sleep data. Variables were standardised and included in the latent profile analysis to derive behavioural patterns. Trained researchers measured children’s height, weight and waist circumference using standardised protocols. Associations of patterns and adiposity measures were tested using multiple linear regression.
Setting:
Melbourne, Australia.
Participants:
A total of 337 children followed up at 6–8 years (T2) and 9–11 years (T3).
Results:
Three patterns derived at 6–8 years were broadly identified to be healthy, unhealthy and mixed patterns. Patterns at 9–11 years were dissimilar except for the unhealthy pattern. Individual behaviours characterising the patterns varied over time. No significant cross-sectional or prospective associations were observed with adiposity at both time points; however, children displaying the unhealthy pattern had higher adiposity measures than other patterns.
Conclusion:
Three non-identical patterns were identified at 6–8 and 9–11 years. The individual behaviours that characterised patterns (dominant behaviours) at both ages are possible drivers of the patterns obtained and could explain the lack of associations with adiposity. Identifying individual behaviour pattern drivers and strategic intervention are key to maintain and prevent the decline of healthy patterns.
Studies show ethnic inequalities in rates of involuntary admission and types of clinical care (such as psychological therapies). However, few studies have investigated if there is a relationship between clinical care practices and ethnic inequalities in involuntary admission.
Aims
This study investigated the impact of ethnicity and clinical care on involuntary admission and the potential mediation effects of prior clinical care.
Method
In this retrospective cohort study, we used data from the electronic records of the South London and Maudsley NHS Foundation Trust and identified patients with a first hospital admission between January 2008 and May 2021. Logistic regression and mediation analyses were used to investigate the association between ethnicity and involuntary admission, and whether clinical care, in the 12 months preceding admission, mediates the association.
Results
Compared with White British people, higher odds of involuntary admission were observed among 10 of 14 minority ethnic groups; with more than twice the odds observed among people of Asian Chinese, of Asian Bangladeshi and of any Black background. There were some ethnic differences in clinical care prior to admission, but these had a minimal impact on the inequalities in involuntary admission. More out-patient appointments and home treatment were associated with higher odds of involuntary admission, whereas psychological therapies and having a care plan were associated with reduced odds of involuntary admission.
Conclusions
Ethnic inequalities in involuntary admission persist after accounting for potential mediating effects of several types and frequencies of clinical care. Promoting access to psychological therapies and ensuring that care plans are in place may reduce involuntary admissions.
There is emerging evidence of heterogeneity within treatment-resistance schizophrenia (TRS), with some people not responding to antipsychotic treatment from illness onset and a smaller group becoming treatment-resistant after an initial response period. It has been suggested that these groups have different aetiologies. Few studies have investigated socio-demographic and clinical differences between early and late onset of TRS.
Objectives
This study aims to investigate socio-demographic and clinical correlates of late-onset of TRS.
Methods
Using data from the electronic health records of the South London and Maudsley, we identified a cohort of people with TRS. Regression analyses were conducted to identify correlates of the length of treatment to TRS. Analysed predictors include gender, age, ethnicity, positive symptoms severity, problems with activities of daily living, psychiatric comorbidities, involuntary hospitalisation and treatment with long-acting injectable antipsychotics.
Results
We observed a continuum of the length of treatment until TRS presentation. Having severe hallucinations and delusions at treatment start was associated shorter duration of treatment until the presentation of TRS.
Conclusions
Our findings do not support a clear cut categorisation between early and late TRS, based on length of treatment until treatment resistance onset. More severe positive symptoms predict earlier onset of treatment resistance.
Disclosure
DFdF, GKS, EF and IR have received research funding from Janssen and H. Lundbeck A/S. RDH and HS have received research funding from Roche, Pfizer, Janssen and Lundbeck. SES is employed on a grant held by Cardiff University from Takeda Pharmaceutical Comp
Ethnic disparities in treatment with clozapine, the antipsychotic recommended for treatment-resistant schizophrenia (TRS), have been reported. However, these investigations frequently suffer from potential residual confounding. For example, few studies have restricted the analyses to TRS samples and none has controlled for benign ethnic neutropenia.
Objectives
This study investigated if service-users’ ethnicity influenced clozapine prescription in a cohort of people with TRS.
Methods
Information from the clinical records of South London and Maudsley NHS Trust was used to identify a cohort of service-users with TRS between 2007 and 2017. In this cohort, we used logistic regression to investigate any association between ethnicity and clozapine prescription while adjusting for potential confounding variables, including sociodemographic factors, psychiatric multimorbidity, substance use, benign ethnic neutropenia, and inpatient and outpatient care received.
Results
We identified 2239 cases that met the criteria for TRS. Results show that after adjusting for confounding variables, people with Black African ethnicity had half the odds of being treated with clozapine and people with Black Caribbean or Other Black background had about two-thirds the odds of being treated with clozapine compared White British service-users. No disparities were observed regarding other ethnic groups, namely Other White background, South Asian, Other Asian, or any other ethnicity.
Conclusions
There was evidence of inequities in care among Black ethnic groups with TRS. Interventions targeting barriers in access to healthcare are recommended.
Disclosure
During the conduction of the study, DFdF, GKS, and RH received funds from the NIHR Maudsley Biomedical Research Centre. For other activities outside the submitted work, DFdF received research funding from the UK Department of Health and Social Care, Janss
Although exposure therapy (ET) is an effective treatment for anxiety disorders and obsessive-compulsive disorder, many clinicians report not utilizing it. The present study targeted common utilization barriers by evaluating an intensive ET training experience in a relatively inexperienced sample of pre-professionals. Thirty-two individuals at the undergraduate or college graduate level without formal clinical experience participated as camp counsellors in a 5day exposure-based therapeutic summer camp for youth with anxiety disorders and/or obsessive-compulsive disorder. Participants were trained in ET through a progressive cascading model and answered questionnaires before and after camp. Repeated measure MANOVA revealed significantly increased feelings of self-efficacy conducting exposures, and significantly decreased feelings of disgust sensitivity and contamination-related disgust from pre-camp to post-camp. A subset of individuals providing data 1 month after the camp maintained a significant gain in ET self-efficacy. Regression analyses revealed that contamination-related disgust, but not disgust sensitivity, significantly predicted post-camp ET self-efficacy. These findings suggest that individuals early into their post-secondary education can learn ET, and the progressive cascading model holds promise in its utility across experience levels and warrants further investigation. Disgust may also play a role in feelings of competency conducting ET. Implications on dissemination and implementation efforts are also discussed.
Key learning aims
(1) How can training of CBT techniques such as exposure occur prior to graduate education?
(2) Can self-efficacy in conducting exposures meaningfully increase in an experiential training of pre-professionals?
(3) How does an individual’s tolerance of disgust impact feelings of competence conducting exposures?
We describe the incidence of suicidality (2007–2017) in people with depression treated by secondary mental healthcare services at South London and Maudsley NHS Trust (n = 26 412). We estimated yearly incidence of ‘suicidal ideation’ and ‘high risk of suicide’ from structured and free-text fields of the Clinical Record Interactive Search system. The incidence of suicidal ideation increased from 0.6 (2007) to 1 cases (2017) per 1000 population. The incidence of high risk of suicide, based on risk forms, varied between 0.06 and 0.50 cases per 1000 adult population (2008–2017). Electronic health records provide the opportunity to examine suicidality on a large scale, but the impact of service-related changes in the use of structured risk assessment should be considered.
Reward Deficiency Syndrome (RDS) is an umbrella term for all drug and nondrug addictive behaviors, due to a dopamine deficiency, “hypodopaminergia.” There is an opioid-overdose epidemic in the USA, which may result in or worsen RDS. A paradigm shift is needed to combat a system that is not working. This shift involves the recognition of dopamine homeostasis as the ultimate treatment of RDS via precision, genetically guided KB220 variants, called Precision Behavioral Management (PBM). Recognition of RDS as an endophenotype and an umbrella term in the future DSM 6, following the Research Domain Criteria (RDoC), would assist in shifting this paradigm.
Ecological models acknowledge the importance of human-environment interactions in understanding and changing behavior. These models incorporate multiple levels of influence on behavior, including policy, community, organizational, social, and individual. Studies applying ecological models to explore health behavior correlates have tended to identify determinants at the individual level, with fewer exploring correlates at the social, physical, and policy levels. While primarily developed to explain human behavior, some ecological models have been further developed to inform interventions to change human behavior, often paired with theories such as social cognitive theory, organizational theory, and behavioral choice theory. Evidence syntheses indicate that ecological models are seldom used to inform intervention design, with the majority focusing on just one or two levels of the model. Most interventions applying ecological models to target child and adolescent health behaviors have reported small effect sizes, while child obesity prevention initiatives targeting factors at multiple levels of influence have shown larger effects. Future research should focus on developing interventions targeting all levels of ecological models, using interventions based on ecological models to change the behavior of whole communities, using ecological models within a systems framework, and exploring how they can assist with the scaling up of interventions to improve population reach.
Trends in detention under the Mental Health Act 1983 in two major London secondary mental healthcare providers were explored using patient-level data in a historical cohort study between 2007–2008 and 2016–2017. An increase in the number of detention episodes initiated per fiscal year was observed at both sites. The rise was accompanied by an increase in the number of active patients; the proportion of active patients detained per year remained relatively stable. Findings suggest that the rise in the number of detentions reflects the rise of the number of people receiving secondary mental healthcare.
The co-production and co-facilitation of recovery-focused education programmes is one way in which service users may be meaningfully involved as partners.
Objectives:
To evaluate the impact of a clinician and peer co-facilitated information programme on service users’ knowledge, confidence, recovery attitudes, advocacy and hope, and to explore their experience of the programme.
Methods:
A sequential design was used involving a pre–post survey to assess changes in knowledge, confidence, advocacy, recovery attitudes and hope following programme participation. In addition, semi-structured interviews with programme participants were completed. Fifty-three participants completed both pre- and post-surveys and twelve individuals consented to interviews.
Results:
The results demonstrated statistically significant changes in service users’ knowledge about mental health issues, confidence and advocacy. These improvements were reflected in the themes which emerged from the interviews with participants (n = 12), who reported enhanced knowledge and awareness of distress and wellness, and a greater sense of hope. In addition, the peer influence helped to normalise experiences for participants, while the dual facilitation engendered equality of participation and increased the opportunity for meaningful collaboration between service users and practitioners.
Conclusions:
The evaluation highlights the potential strengths of a service user and clinician co-facilitated education programme that acknowledges and respects the difference between the knowledge gained through self-experience and the knowledge gained through formal learning.
Parisite-(La) (IMA2016-031), ideally CaLa2(CO3)3F2, occurs in a hydrothermal vein crosscutting a metarhyolite of the Rio dos Remédios Group, at the Mula mine, Tapera village, Novo Horizonte county, Bahia, Brazil, associated with hematite, rutile, almeidaite, fluocerite-(Ce), brockite, monazite-(La), rhabdophane-(La) and bastnäsite-(La). Parisite-(La) occurs as residual nuclei (up to 5 mm) in steep doubly-terminated pseudo-hexagonal pyramidal crystals (up to 8.2 cm). Parisite-(La) is transparent, yellow-green to white, with a white streak and displays a vitreous (when yellow-green) to dull (when white) lustre. Cleavage is distinct on pseudo-{001}; fracture is laminated, conchoidal, or uneven. The Mohs hardness is 4 to 5, and it is brittle. Calculated density is 4.273 g cm−3. Parisite-(La) is pseudo-uniaxial (+), ω = 1.670(2) and ε = 1.782(5) (589 nm). The empirical formula normalized on the basis of 11 (O + F) atoms per formula unit (apfu) is Ca0.98(La0.83Nd0.51Ce0.37Pr0.16Sm0.04Y0.03)Σ1.94C3.03O8.91F2.09. The IR spectrum confirms the absence of OH groups. Single-crystal X-ray studies gave the following results: monoclinic (pseudo-trigonal), space group: C2, Cm, or C2/m, a = 12.356(1) Å, b = 7.1368(7) Å, c = 28.299(3) Å, β = 98.342(4)°, V = 2469.1(4) Å3 and Z = 12. Parisite-(La) is the La-dominant analogue of parisite-(Ce).
Natural samples of the substituted basic Cu(II) chloride series, Cu4–xMx2+(OH)6Cl2(M = Zn, Ni, or Mg) were investigated by single-crystal X-ray diffraction in order to elucidate compositional boundaries associated with paratacamite and its congeners. The compositional ranges examined are Cu3.65Zn0.35(OH)6Cl2 – Cu3.36Zn0.64(OH)6Cl2 and Cu3.61Ni0.39(OH)6Cl2 – Cu3.13Ni0.87(OH)6Cl2, along with a single Mg-bearing phase. The majority of samples studied have trigonal symmetry (R3̄m) analogous to that of herbertsmithite (Zn) and gillardite (Ni), with a ≈ 6.8, c ≈ 14.0 Å. Crystallographic variations for these samples caused by composition are compared with both published and new data for the R3̄m sub-cell of paratacamite, paratacamite-(Mg) and paratacamite-(Ni). The observed trends suggest that the composition of end-members associated with the paratacamite congeners depend upon the nature of the substituting cation.
Hydroxycalciomicrolite, Ca1.5Ta2O6(OH) is a new microlite-group mineral found in the Volta Grande pegmatite, Nazareno, Minas Gerais, Brazil. It occurs as isolated octahedral and as a combination of octahedral and rhombic dodecahedral crystals, up to1.5 mm in size. The crystals are yellow and translucent, with a white streak and vitreous to resinous lustre. The mineral is brittle, with a Mohs hardness of 5–6. Cleavage is not observed and fracture is conchoidal. The calculated density is 6.176 g cm–3. Hydroxycalciomicroliteis isotropic, ncalc. = 2.010. The infrared and Raman spectra exhibit bands due to O–H stretching vibrations. The chemical composition determined from electron microprobe analysis (n = 13) is (wt.%): Na2O 0.36(8), CaO 15.64(13), SnO2 0.26(3),Nb2O5 2.82(30), Ta2O5 78.39(22), MnO 0.12(2), F 0.72(12) and H2O 1.30 (from the crystal structure data), O = F –0.30, total 99.31(32), yielding an empirical formula, (Ca1.48Na0.06Mn0.01)∑1.55(Ta1.88Nb0.11Sn0.01)∑2.00O6.00[(OH)0.76F0.20O0.04].Hydroxycalciomicrolite is cubic, with unit-cell parameters a = 10.4205(1) Å, V = 1131.53(2) Å3 and Z = 8. It represents a pyrochlore supergroup, microlite-group mineral exhibiting P4332 symmetry, instead of Fd3m. Thereduction in symmetry is due to long-range ordering of Ca and vacancies on the A sites. This is the first example of such ordering in a natural pyrochlore, although it is known from synthetic compounds. This result is promising because it suggests that other species with P4332or lower-symmetry space group can be discovered and characterized.
The Hubble Source Catalog (HSC) combines lists of sources detected on images obtained with the WFPC2, ACS and WFC3 instruments aboard the Hubble Space Telescope (HST) and now available in the Hubble Legacy Archive. The catalogue contains time-domain information for about two million of its sources detected using the same instrument and filter on at least five HST visits. The Hubble Catalog of Variables (HCV) aims to identify HSC sources showing significant brightness variations. A magnitude-dependent threshold in the median absolute deviation of photometric measurements (an outlier-resistant measure of light-curve scatter) is adopted as the variability detection statistic. It is supplemented with a cut in χred2 that removes sources with large photometric errors. A pre-processing procedure involving bad image identification, outlier rejection and computation of local magnitude zero-point corrections is applied to the HSC light-curves before computing the variability detection statistics. About 52 000 HSC sources have been identified as candidate variables, among which 7,800 show variability in more than one filter. Visual inspection suggests that ∼70% of the candidates detected in multiple filters are true variables, while the remaining ∼30% are sources with aperture photometry corrupted by blending, imaging artefacts or image processing anomalies. The candidate variables have AB magnitudes in the range 15–27m, with a median of 22m. Among them are the stars in our own and nearby galaxies, and active galactic nuclei.
Free-range laying hen systems are increasing within Australia. The pullets for these systems are typically reared indoors before being provided first range access around 21 to 26 weeks of age. Thus, the rearing and laying environments are disparate and hens may not adapt well to free-range housing. In this study, we reared 290 Hy-Line® Brown day-old chicks divided into two rooms each with feed, water and litter. In the enriched room, multiple structural, manipulable, visual and auditory stimuli were also provided from 4 to 21 days, the non-enriched room had no additional objects or stimuli. Pullets were transferred to the laying facility at 12 weeks of age and divided into six pens (three enriched-reared, three non-enriched-reared) with identical indoor resources and outdoor range area. All birds were first provided range access at 21 weeks of age. Video observations of natural disturbance behaviours on the range at 22 to 23 and 33 to 34 weeks of age showed no differences in frequency of disturbance occurrences between treatment groups (P=0.09) but a decrease in disturbance occurrences over time (P<0.0001). Radio-frequency identification tracking of individually tagged birds from 21 to 37 weeks of age showed enriched birds on average, spent less time on the range each day (P<0.04) but with a higher number of range visits than non-enriched birds from 21 to 24 weeks of age (P=0.01). Enriched birds accessed the range on more days (P=0.03) but over time, most birds in both treatment groups accessed the range daily. Basic external health scoring showed minimal differences between treatment groups with most birds in visibly good condition. At 38 weeks of age all birds were locked inside for 2 days and from 40 to 42 weeks of age the outdoor range was reduced to 20% of its original size to simulate stressful events. The eggs from non-enriched birds had higher corticosterone concentrations following lock-in and 2 weeks following range reduction compared with the concentrations within eggs from enriched birds (P<0.0001). Correspondingly, the enriched hens showing a greater increase in the number of visits following range area reduction compared to non-enriched hens (P=0.02). Only one rearing room per treatment was used but these preliminary data indicate 3 weeks of early enrichment had some long-term effects on hen ranging behaviour and enhanced hen’s adaptability to environmental stressors.
Free-range laying hen systems are increasing within Australia and research is needed to determine optimal outdoor stocking densities. Six small (n=150 hens) experimental flocks of ISA Brown laying hens were housed with access to ranges simulating one of three outdoor stocking densities with two pen replicates per density: 2000 hens/ha, 10 000 hens/ha or 20 000 hens/ha. Birds were provided daily range access from 21 to 36 weeks of age and the range usage of 50% of hens was tracked using radio-frequency identification technology. Throughout the study, basic external health assessments following a modified version of the Welfare Quality® protocol showed most birds were in visibly good condition (although keel damage was increasingly present with age) with few differences between stocking densities. Toenail length at 36 weeks of age was negatively correlated with hours spent ranging for all pens of birds (all r⩾−0.23, P⩽0.04). At 23 weeks of age, there were no differences between outdoor stocking densities in albumen corticosterone concentrations (P=0.44). At 35 weeks of age, density effects were significant (P<0.001) where the eggs from hens in the highest outdoor stocking density showed the highest albumen corticosterone concentrations, although eggs from hens in the 10 000 hens/ha density showed the lowest concentrations (P<0.017). Behavioural observations of hens both on the range and indoors showed more dust bathing and foraging (scratching followed by ground-pecking) was performed outdoors, but more resting indoors (all P<0.001). Hens from the 2000 hens/ha densities showed the least foraging on the range but the most resting outdoors, with hens from the 20 000 hens/ha densities showing the least amount of resting outdoors (all P<0.017). Proportions of dust bathing outdoors tended to differ between the stocking densities (P=0.08). For each of the health and behavioural measures there were differences between pen replicates within stocking densities. These data show outdoor stocking density has some effects on hen welfare, and it appears that consideration of both individual and group-level behaviour is necessary when developing optimal stocking density guidelines and free-range system management practices.
Northern bobwhite (Colinus virginianus) and scaled quail (Callipepla squamata) have experienced chronic declines within the Rolling Plains ecoregion of Texas. Parasitic infection, which has long been dismissed as a problem in quail, has not been studied thoroughly until recently. A total of 219 northern bobwhite and 101 scaled quail from Mitchell County, Texas were captured and donated from 2014 to 2015, and examined for eyeworm (Oxyspirura petrowi) and caecal worm (Aulonocephalus pennula) infections. In 2014, bobwhites averaged 19.6 ± 1.8 eyeworms and 98.6 ± 8.2 caecal worms, and 23.5 ± 2.1 eyeworms and 129.9 ± 10.7 caecal worms in 2015. Scaled quail averaged 4.8 ± 1.0 eyeworms and 50 ± 6.8 caecal worms in 2014, and 5.7 ± 1.3 eyeworms and 38.1 ± 7.1 caecal worms in 2015. This study expands the knowledge of parasitic infection in quail inhabiting the Rolling Plains of Texas. A significant difference was documented in O. petrowi infection between species but there was no significant difference in A. pennula between quail species. No significant difference was detected in parasite infection between the sexes of both northern bobwhite and scaled quail. This study also documented the highest reported O. petrowi infection in both species of quail. Additional research is needed on the life history and infection dynamics of O. petrowi and A. pennula infections to determine if there are individual- and/or population-level implications due to parasitic infection.
Anxiety and depression are common following traumatic brain injury (TBI), often co-occurring. This study evaluated the efficacy of a 9-week cognitive behavioral therapy (CBT) program in reducing anxiety and depression and whether a three-session motivational interviewing (MI) preparatory intervention increased treatment response.
Method
A randomized parallel three-group design was employed. Following diagnosis of anxiety and/or depression using the Structured Clinical Interview for DSM-IV, 75 participants with mild-severe TBI (mean age 42.2 years, mean post-traumatic amnesia 22 days) were randomly assigned to an Adapted CBT group: (1) MI + CBT (n = 26), or (2) non-directive counseling (NDC) + CBT (n = 26); or a (3) waitlist control (WC, n = 23) group. Groups did not differ in baseline demographics, injury severity, anxiety or depression. MI and CBT interventions were guided by manuals adapted for individuals with TBI. Three CBT booster sessions were provided at week 21 to intervention groups.
Results
Using intention-to-treat analyses, random-effects regressions controlling for baseline scores revealed that Adapted CBT groups (MI + CBT and NDC + CBT) showed significantly greater reduction in anxiety on the Hospital Anxiety and Depression Scale [95% confidence interval (CI) −2.07 to −0.06] and depression on the Depression Anxiety and Stress Scale (95% CI −5.61 to −0.12) (primary outcomes), and greater gains in psychosocial functioning on Sydney Psychosocial Reintegration Scale (95% CI 0.04–3.69) (secondary outcome) over 30 weeks post-baseline relative to WC. The group receiving MI + CBT did not show greater gains than the group receiving NDC + CBT.
Conclusions
Findings suggest that modified CBT with booster sessions over extended periods may alleviate anxiety and depression following TBI.