5 results
Effect of lifestyle, medication and ethnicity on cardiometabolic risk in the year following the first episode of psychosis: prospective cohort study
- Fiona Gaughran, Daniel Stahl, Dominic Stringer, David Hopkins, Zerrin Atakan, Kathryn Greenwood, Anita Patel, Shubulade Smith, Poonam Gardner-Sood, John Lally, Margaret Heslin, Brendon Stubbs, Stefania Bonaccorso, Anna Kolliakou, Oliver Howes, David Taylor, Marta Di Forti, Anthony S. David, Robin M. Murray, Khalida Ismail, the IMPACT team
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- Journal:
- The British Journal of Psychiatry / Volume 215 / Issue 6 / December 2019
- Published online by Cambridge University Press:
- 26 July 2019, pp. 712-719
- Print publication:
- December 2019
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Background
The first episode of psychosis is a critical period in the emergence of cardiometabolic risk.
AimsWe set out to explore the influence of individual and lifestyle factors on cardiometabolic outcomes in early psychosis.
MethodThis was a prospective cohort study of 293 UK adults presenting with first-episode psychosis investigating the influence of sociodemographics, lifestyle (physical activity, sedentary behaviour, nutrition, smoking, alcohol, substance use) and medication on cardiometabolic outcomes over the following 12 months.
ResultsRates of obesity and glucose dysregulation rose from 17.8% and 12%, respectively, at baseline to 23.7% and 23.7% at 1 year. Little change was seen over time in the 76.8% tobacco smoking rate or the quarter who were sedentary for over 10 h daily. We found no association between lifestyle at baseline or type of antipsychotic medication prescribed with either baseline or 1-year cardiometabolic outcomes. Median haemoglobin A1c (HbA1c) rose by 3.3 mmol/mol in participants from Black and minority ethnic (BME) groups, with little change observed in their White counterparts. At 12 months, one-third of those with BME heritage exceeded the threshold for prediabetes (HbA1c >39 mmol/mol).
ConclusionsUnhealthy lifestyle choices are prevalent in early psychosis and cardiometabolic risk worsens over the next year, creating an important window for prevention. We found no evidence, however, that preventative strategies should be preferentially directed based on lifestyle habits. Further work is needed to determine whether clinical strategies should allow for differential patterns of emergence of cardiometabolic risk in people of different ethnicities.
Meniscus Guide Slot-Die Coating For Roll-to-Roll Perovskite Solar Cells
- Daniel Burkitt, Peter Greenwood, Katherine Hooper, David Richards, Vasil Stoichkov, David Beynon, Eifion Jewell, Trystan Watson
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- Journal:
- MRS Advances / Volume 4 / Issue 24 / 2019
- Published online by Cambridge University Press:
- 30 January 2019, pp. 1399-1407
- Print publication:
- 2019
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Roll-to-roll slot-die coating with a meniscus guide is used to deposit several layers in a P-I-N perovskite solar cell stack, including the perovskite layer. The use of various length meniscus guides as part of the slot-die head allows controlled coating of these layers at a common coating speed. The length of meniscus guide used is optimised and related to the rheology of the coated ink and appropriate choice of meniscus guide length provides a way to avoid flooding of the coated area and improve coating definition. Initial coating trial results suggest the low-flow limit of slot-die coating is still applicable when using a meniscus guide, which is an important and previously unreported observation, application of this theory to meniscus guide coating provides a useful tool for rapidly determining the appropriate coating conditions that can be used as part of a manufacturing process. This is further explored through the deposition of perovskite solar cells by roll-to-roll slot-die coating. The perovskite layer is deposited using a sequential slot-die deposition process using a low toxicity dimethyl sulfoxide ink for the lead iodide layer, it is found that increasing the drying oven temperature and air flow rate can be used to improve the uniformity of the layer but this can also result in deformation of the plastic substrate. Functioning perovskite solar cells are demonstrated using this technique, but a large variation is found between device performances which is attributed to the poor uniformity of the perovskite layer and damage caused to the substrate by excessive heating.
Structured lifestyle education for people with schizophrenia, schizoaffective disorder and first-episode psychosis (STEPWISE): randomised controlled trial
- Richard I. G. Holt, Rebecca Gossage-Worrall, Daniel Hind, Michael J. Bradburn, Paul McCrone, Tiyi Morris, Charlotte Edwardson, Katharine Barnard, Marian E. Carey, Melanie J. Davies, Chris M. Dickens, Yvonne Doherty, Angela Etherington, Paul French, Fiona Gaughran, Kathryn E. Greenwood, Sridevi Kalidindi, Kamlesh Khunti, Richard Laugharne, John Pendlebury, Shanaya Rathod, David Saxon, David Shiers, Najma Siddiqi, Elizabeth A. Swaby, Glenn Waller, Stephen Wright
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- Journal:
- The British Journal of Psychiatry / Volume 214 / Issue 2 / February 2019
- Published online by Cambridge University Press:
- 25 September 2018, pp. 63-73
- Print publication:
- February 2019
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Background
Obesity is a major challenge for people with schizophrenia.
AimsWe assessed whether STEPWISE, a theory-based, group structured lifestyle education programme could support weight reduction in people with schizophrenia.
MethodIn this randomised controlled trial (study registration: ISRCTN19447796), we recruited adults with schizophrenia, schizoaffective disorder or first-episode psychosis from ten mental health organisations in England. Participants were randomly allocated to the STEPWISE intervention or treatment as usual. The 12-month intervention comprised four 2.5 h weekly group sessions, followed by 2-weekly maintenance contact and group sessions at 4, 7 and 10 months. The primary outcome was weight change after 12 months. Key secondary outcomes included diet, physical activity, biomedical measures and patient-related outcome measures. Cost-effectiveness was assessed and a mixed-methods process evaluation was included.
ResultsBetween 10 March 2015 and 31 March 2016, we recruited 414 people (intervention 208, usual care 206) with 341 (84.4%) participants completing the trial. At 12 months, weight reduction did not differ between groups (mean difference 0.0 kg, 95% CI −1.6 to 1.7, P = 0.963); physical activity, dietary intake and biochemical measures were unchanged. STEPWISE was well-received by participants and facilitators. The healthcare perspective incremental cost-effectiveness ratio was £246 921 per quality-adjusted life-year gained.
ConclusionsParticipants were successfully recruited and retained, indicating a strong interest in weight interventions; however, the STEPWISE intervention was neither clinically nor cost-effective. Further research is needed to determine how to manage overweight and obesity in people with schizophrenia.
Declaration of interestR.I.G.H. received fees for lecturing, consultancy work and attendance at conferences from the following: Boehringer Ingelheim, Eli Lilly, Janssen, Lundbeck, Novo Nordisk, Novartis, Otsuka, Sanofi, Sunovion, Takeda, MSD. M.J.D. reports personal fees from Novo Nordisk, Sanofi-Aventis, Lilly, Merck Sharp & Dohme, Boehringer Ingelheim, AstraZeneca, Janssen, Servier, Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceuticals International Inc.; and, grants from Novo Nordisk, Sanofi-Aventis, Lilly, Boehringer Ingelheim, Janssen. K.K. has received fees for consultancy and speaker for Novartis, Novo Nordisk, Sanofi-Aventis, Lilly, Servier and Merck Sharp & Dohme. He has received grants in support of investigator and investigator-initiated trials from Novartis, Novo Nordisk, Sanofi-Aventis, Lilly, Pfizer, Boehringer Ingelheim and Merck Sharp & Dohme. K.K. has received funds for research, honoraria for speaking at meetings and has served on advisory boards for Lilly, Sanofi-Aventis, Merck Sharp & Dohme and Novo Nordisk. D.Sh. is expert advisor to the NICE Centre for guidelines; board member of the National Collaborating Centre for Mental Health (NCCMH); clinical advisor (paid consultancy basis) to National Clinical Audit of Psychosis (NCAP); views are personal and not those of NICE, NCCMH or NCAP. J.P. received personal fees for involvement in the study from a National Institute for Health Research (NIHR) grant. M.E.C. and Y.D. report grants from NIHR Health Technology Assessment, during the conduct of the study; and The Leicester Diabetes Centre, an organisation (employer) jointly hosted by an NHS Hospital Trust and the University of Leicester and who is holder (through the University of Leicester) of the copyright of the STEPWISE programme and of the DESMOND suite of programmes, training and intervention fidelity framework that were used in this study. S.R. has received honorarium from Lundbeck for lecturing. F.G. reports personal fees from Otsuka and Lundbeck, personal fees and non-financial support from Sunovion, outside the submitted work; and has a family member with professional links to Lilly and GSK, including shares. F.G. is in part funded by the National Institute for Health Research Collaboration for Leadership in Applied Health Research & Care Funding scheme, by the Maudsley Charity and by the Stanley Medical Research Institute and is supported by the by the Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London.
6 - Bad apples, bad barrels and bad cellars: a “boundaries” perspective on professional misconduct
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- By Daniel Muzio, University of Newcastle, James Faulconbridge, Lancaster University Management School, UK, Claudia Gabbioneta, Newcastle University Business School, UK, Royston Greenwood, University of Alberta, Canada
- Edited by Donald Palmer, University of California, Davis, Kristin Smith-Crowe, University of Utah, Royston Greenwood, University of Alberta
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- Book:
- Organizational Wrongdoing
- Published online:
- 05 July 2016
- Print publication:
- 18 July 2016, pp 141-175
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Summary
Parmalat – formerly one of the largest dairy companies in the world – went bankrupt on December 24, 2003, leaving behind a “hole” of 14 billion euros, a sum almost twice the company's 2002 sales turnover. Subsequent investigations revealed that the company's financial accounts had consistently and deliberately been falsified for each of the thirteen years that Parmalat was listed on the Milan Stock Exchange. During those years, professionals – who are supposed to act as gatekeepers (Coffee 2005, 2006) – did not (or, in some cases, decided not to) see what was going on. Deloitte – which was auditing the company's group accounts – did not raise any concerns until October 2003 when they issued a disclaimer on the company's accounts, as they could not determine the amount of a fund held by a subsidiary. Standard and Poor's constantly rated the company at the investment grade and even improved its outlook only a few months before the company defaulted. Securities analysts, similarly, remained positive on Parmalat's shares until the company was already on the verge of bankruptcy; only a few days before the fraud was detected, fifty-seven of sixty-six of their equity research reports recommended buying or holding the company's shares.
Enron's story, one of the biggest scandals in American history, is not much different, although it took place in the supposedly more developed US stock market. As in the Parmalat story, professionals did not effectively perform their ascribed roles. Arthur Andersen, the company's auditors, consistently approved Enron's accounts without raising any concerns and failed to inform “the company's audit committee about both the accounting policies in use at Enron and the unusual transactions the company had conducted” (Batson Report 2003: 40–41). Management consultancies such as McKinsey, which advised Enron, endorsed its strategic repositioning and praised its “asset light” strategy (Kipping, Kirkpatrick, and Muzio 2006). Not until four days before bankruptcy was declared on December 2, 2001, did rating agencies lower their ratings of the company to below the mark of a safe investment. As late as October in the same year, fifteen securities analysts rated Enron a “buy” and twelve of them recommended it as a “strong buy.”
9 - The New Deal on Data: A Framework for Institutional Controls
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- By Daniel Greenwood, Massachusetts Institute of Technology, Arkadiusz Stopczynski, Technical University of Denmark, Brian Sweatt, Massachusetts Institute of Technology, Thomas Hardjono, MIT Kerberos & Internet Trust Consortium, Alex Pentland, Massachusetts Institute of Technology
- Edited by Julia Lane, Victoria Stodden, Columbia University, New York, Stefan Bender, Helen Nissenbaum, New York University
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- Book:
- Privacy, Big Data, and the Public Good
- Published online:
- 05 July 2014
- Print publication:
- 09 June 2014, pp 192-210
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Summary
Introduction
In order to realize the promise of a Big Data society and to reduce the potential risk to individuals, institutions are updating the operational frameworks which govern the business, legal, and technical dimensions of their internal organizations. In this chapter we outline ways to support the emergence of such a society within the framework of the New Deal on Data, and describe future directions for research and development.
In our view, the traditional control points relied on as part of corporate governance, management oversight, legal compliance, and enterprise architecture must evolve and expand to match operational frameworks for big data. These controls must support and reflect greater user control over personal data, as well as large-scale interoperability for data sharing between and among institutions. The core capabilities of these controls should include responsive rule-based systems governance and fine-grained authorizations for distributed rights management.
The New Realities of Living in a Big Data Society
Building an infrastructure that sustains a healthy, safe, and efficient society is, in part, a scientific and engineering challenge which dates back to the 1800s when the Industrial Revolution spurred rapid urban growth. That growth created new social and environmental problems. The remedy then was to build centralized networks that delivered clean water and safe food, enabled commerce, removed waste, provided energy, facilitated transportation, and offered access to centralized health care, police, and educational services. These networks formed the backbone of society as we know it today.