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It remains unclear which individuals with subthreshold depression benefit most from psychological intervention, and what long-term effects this has on symptom deterioration, response and remission.
Aims
To synthesise psychological intervention benefits in adults with subthreshold depression up to 2 years, and explore participant-level effect-modifiers.
Method
Randomised trials comparing psychological intervention with inactive control were identified via systematic search. Authors were contacted to obtain individual participant data (IPD), analysed using Bayesian one-stage meta-analysis. Treatment–covariate interactions were added to examine moderators. Hierarchical-additive models were used to explore treatment benefits conditional on baseline Patient Health Questionnaire 9 (PHQ-9) values.
Results
IPD of 10 671 individuals (50 studies) could be included. We found significant effects on depressive symptom severity up to 12 months (standardised mean-difference [s.m.d.] = −0.48 to −0.27). Effects could not be ascertained up to 24 months (s.m.d. = −0.18). Similar findings emerged for 50% symptom reduction (relative risk = 1.27–2.79), reliable improvement (relative risk = 1.38–3.17), deterioration (relative risk = 0.67–0.54) and close-to-symptom-free status (relative risk = 1.41–2.80). Among participant-level moderators, only initial depression and anxiety severity were highly credible (P > 0.99). Predicted treatment benefits decreased with lower symptom severity but remained minimally important even for very mild symptoms (s.m.d. = −0.33 for PHQ-9 = 5).
Conclusions
Psychological intervention reduces the symptom burden in individuals with subthreshold depression up to 1 year, and protects against symptom deterioration. Benefits up to 2 years are less certain. We find strong support for intervention in subthreshold depression, particularly with PHQ-9 scores ≥ 10. For very mild symptoms, scalable treatments could be an attractive option.
It is now over thirty years since epidemiological studies revealed a relationship between low birth weight and subsequent risk of developing traditionally adult-onset diseases, such as type 2 diabetes, cardiovascular and renal disease. Initial focus was directed towards the importance of fetal undernutrition. However, it is now recognized that a range of other in utero adverse exposures including chronic fetal hypoxia, maternal over-nutrition and maternal stress can also lead to increased risk of cardio-metabolic and renal diseases in later life. Animal models, including those using non-human primates, sheep and rodents have been critical in demonstrating causality of relationships and helped to define underlying mechanisms, such as epigenetic programming of gene expression and oxidative stress. As the field moves forward in the coming years, these mechanistic studies will help to identify rational intervention strategies to reduce the developmental programming of cardiometabolic and renal dysfunction in suboptimal pregnancy.
The coronavirus disease 2019 (COVID-19) created major disruptions at academic centers and healthcare systems globally. Clinical and Translational Science Awards (CTSA) fund hubs supported by the National Center for Advancing Translational Sciences provideinfrastructure and leadership for clinical and translational research at manysuch institutions.
Methods:
We surveyed CTSA hubs and received responses from 94% of them regarding the impact of the pandemic and the processes employed for the protection of research personnel and participants with respect to the conduct of research, specifically for studies unrelated to COVID-19.
Results:
In this report, we describe the results of the survey findings in the context of the current understanding of disease transmission and mitigation techniques.
Conclusions:
We reflect on common practices and provide recommendations regarding lessons learned that will be relevant to future pandemics, particularly with regards to staging the cessation and resumption of research activities with an aim to keep the workforce, research participants, and our communities safe in future pandemics.
The Rapid ASKAP Continuum Survey (RACS) is the first large-area survey to be conducted with the full 36-antenna Australian Square Kilometre Array Pathfinder (ASKAP) telescope. RACS will provide a shallow model of the ASKAP sky that will aid the calibration of future deep ASKAP surveys. RACS will cover the whole sky visible from the ASKAP site in Western Australia and will cover the full ASKAP band of 700–1800 MHz. The RACS images are generally deeper than the existing NRAO VLA Sky Survey and Sydney University Molonglo Sky Survey radio surveys and have better spatial resolution. All RACS survey products will be public, including radio images (with $\sim$ 15 arcsec resolution) and catalogues of about three million source components with spectral index and polarisation information. In this paper, we present a description of the RACS survey and the first data release of 903 images covering the sky south of declination $+41^\circ$ made over a 288-MHz band centred at 887.5 MHz.
We describe an ultra-wide-bandwidth, low-frequency receiver recently installed on the Parkes radio telescope. The receiver system provides continuous frequency coverage from 704 to 4032 MHz. For much of the band (${\sim}60\%$), the system temperature is approximately 22 K and the receiver system remains in a linear regime even in the presence of strong mobile phone transmissions. We discuss the scientific and technical aspects of the new receiver, including its astronomical objectives, as well as the feed, receiver, digitiser, and signal processor design. We describe the pipeline routines that form the archive-ready data products and how those data files can be accessed from the archives. The system performance is quantified, including the system noise and linearity, beam shape, antenna efficiency, polarisation calibration, and timing stability.
The genus Diorhabda (Coleoptera: Chrysomelidae) was recently revised, using morphological characters, into five tamarisk-feeding species, four of which have been used in the tamarisk (Tamarix spp.) biological control program in North America and are the subject of these studies. The taxonomic revision is here supported using molecular genetic and hybridization studies. Four Diorhabda species separated into five clades using cytochrome c oxidase subunit 1 sequence data with Diorhabda elongata separating into two clades. Amplified fragment length polymorphism (AFLP) analysis using genomic DNA revealed only four clades, which corresponded to the four morphospecies. Hybridization between the four species yielded viable eggs in F1 crosses but viability was significantly lower than achieved with intraspecific crosses. Crosses involving Diorhabda carinulata and the other three species resulted in low F2 egg viability, whereas crosses between D. elongata, Diorhabda sublineata and Diorhabda carinata resulted in > 40% F2 egg viability. Crosses between D. carinulata and the other three species resulted in high mortality of D. carinulata females due to genital mismatch. AFLP patterns combined with principal coordinates analysis enabled effective separation between D. elongata and D. sublineata, providing a method to measure genetic introgression in the field.
Many political scientists and historians attribute the candidate-centered campaign, a defining characteristic of the modern American political system, to the appearance of the direct primary during the Progressive Era. During the nineteenth century, when the major parties selected their nominees in conventions, office seekers maintained a lower profile, and partisan-minded voters were not overly influenced by the personal characteristics of the candidates. Using California as a case study, this essay traces the emergence of a new breed of aggressive office seekers at the turn of the twentieth century. It looks specifically at the canvassing activities of would-be gubernatorial nominees in the weeks leading up to the state convention. In its heyday, the convention system marginalized elective office seekers. The multilayered convention system was too decentralized and complex to be manipulated in the interests any one candidate. Candidates began to exert more influence over the nomination process in the waning years of the nominating convention. The introduction of state regulation of party functions took control of the process out of the hands of local partisan clubs and cliques. Delegates began to be selected on the basis of their affiliation with a gubernatorial candidate. Conventions lost much of their deliberative character, and voting blocs emerged tied to particular candidates through the unit rule. By the time the direct primary appeared on the scene in 1909, the aggressive office seeker was already a fixture on the political landscape. In short, scholars have exaggerated the impact of the shift from indirect to direct nominations and have overlooked the implications of the regulation of political parties when the convention system was still in place. The direct primary was part of a long tradition of reform designed to serve the interests of the parties' office-seeking or office-holding contingent at the expense of the party organization.
During the nineteenth century American political parties selected their candidates for elective offices in conventions. Around 1910 most states established a system of direct primaries whereby the voters selected their parties' nominees for public office. This book examines the transition from the indirect to the direct primary, as well as its implications for American politics. It offers a systematic analysis of the convention system in four states (New Jersey, Michigan, Colorado and California) and the legislative history of the regulation of political parties during the Progressive Era. It argues that the major political parties themselves were chiefly responsible for doing away with the nominating convention. Candidates played a pivotal role in inaugurating the new nominating system as they became more open and aggressive in pursuit of their parties' nominations. The convention system was never designed to withstand the pressures exerted on it by a more competitive nominating process.
After his name was presented to California's Republican State Convention as a candidate for governor in 1861, Leland Stanford mounted the podium. He was acutely conscious that this was not the first time he stood in line for party favor. Conventions past had nominated Stanford for state treasurer and governor, but he wanted it clearly understood that ambition had nothing to do with it. “I never was a candidate for the nomination upon my own motion…. I did not solicit those nominations, but I submitted because I was devoted to the principles of our party. (Applause.) I felt it was my duty, as it was the duty of every man, to serve when called upon in times of trial.” Stanford assured the assembly that this was no less true in 1861. “No gentleman in this convention has ever received a letter in regard to this gubernatorial contest, [sic] from me during my absence from the State. There is not to-day, in this convention, a gentleman who ever received a letter from me in regard to it.” The impetus for his candidacy originated elsewhere. “My friends insisted that my name should come before the people, and so I have consented.” He closed by reminding his listeners that “This is not a struggle between men, we are here to-day for the purpose of sustaining principles.”
Raw political ambition was still a vice in the eyes of many nineteenth-century Americans.
Michigan's voters had never witnessed anything resembling Chase S. Osborn's barnstorming for the Republican gubernatorial nomination in 1910. Touring the lower peninsula in an automobile caravan over several weeks that summer, Osborn's entourage logged in twelve thousand miles – sometimes tooling along at an alarming thirty miles per hour. The “cow path campaigning” stopped “wherever we found a crossroads, a blacksmith shop and a bird's nest.” His savvy handlers sent an organizer to towns ahead to ensure that Osborn was greeted by a band and an enthusiastic crowd. Osborn was a “natural campaigner,” writes his biographer, “energetic, colorful, highly egotistical, a complete extrovert” and a good public speaker. Primary day left him hoarse from seven hundred mostly extemporaneous speeches. Osborn gloried in the glad-handing techniques perfected by candidates for lesser offices, but he did not overlook the tactics that had nominated governors past. He wrote numerous letters, hired a retinue of local campaign promoters, and even sought to enlist the census takers in his cause. It proved to be an expensive undertaking. Much of the thirty-five thousand dollars Osborn spent came out of his own bank account after his fellow mine owners proved less than generous. Some of the payments violated the state's new limitations on campaign expenditures, but it was easy enough to find loopholes in the statute. A longtime supporter of direct nominations, Osborn's ready adaptation to its demanding regimen accounted for his victory that fall.
In the near total absence of official records of convention proceedings, local newspapers furnished the list of state delegates. Information on occupations appeared in city directories published in the same year as the state convention. Directories published the year after the state convention were consulted for delegates who were not found in the previous edition. Some names appeared without an occupation. In about half these cases, a directory published two or four years earlier revealed an occupation that was the one assigned for this study. Individuals traced back in earlier directories had to retain the same address. Persons with “No Occupation” in Figures 2.3 and 2.4 and Tables 3.1, 3.2 and 3.3 either had no occupation listed in the directory over a period of four years or, more commonly, could not be located in the earlier editions.
When the names appearing in each source exactly match, as they do in most instances, record linkage was simple and reasonably sure. There were a number of “close fits” that required a judgment call. In the interest of consistency and of mitigating subjectivity, the following guidelines determined when a match from the newspapers and directories was inferred:
First and last names had to conform – with rare allowances for variations on abridged first names or common nicknames; for example, “Augustus” in one source appears as “Gus” in the other.
When more than one individual with a given name appeared in the directory, an address singled out the individual living in or near (within 1 block) of the appropriate ward.
As the twice-elected chief executive of New Jersey's largest city, James M. Seymour was an obvious choice for governor in 1898. The Newark mayor never formally announced his candidacy for the Democratic nomination, but did admit that were it tendered him, “he would consider himself … constrained to accept.” Seymour needed a friendly delegation from his home county of Essex to the state convention to make his candidacy viable. The mayor's friends mounted a well-organized effort to carry the primaries, outdoing anything attempted by any previous gubernatorial aspirant. They had to be more aggressive because of the hostility of the local Democratic organization. Seymour's patronage practices had alienated many the party's leaders, a common source of strife that ended many an incumbent's political career. The turmoil that engulfed the ensuing primary revealed the deficiencies of the party-administered indirect primary when faced with a highly visible and contentious struggle for party supremacy.
Ostensibly, the Newark mayor's candidacy appeared formidable. His opponent, Elvin W. Crane, was an obscure politician who had served two terms in the state assembly a decade earlier. “[O]n his merits and popularity Mr. Crane would never have had a ghost of a chance of being nominated for governor,” the Newark Evening News editorialized.