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Associations Between Depression and Cardiometabolic Health: A 27-Year Longitudinal Study – Corrigendum
- Hillary L. Ditmars, Mark W. Logue, Rosemary Toomey, Ruth E. McKenzie, Carol E. Franz, Matthew S. Panizzon, Chandra A. Reynolds, Kristy N. Cuthbert, Richard Vandiver, Daniel E. Gustavson, Graham M. L. Eglit, Jeremy A. Elman, Mark Sanderson-Cimino, McKenna E. Williams, Ole A. Andreassen, Anders M. Dale, Lisa T. Eyler, Christine Fennema-Notestine, Nathan A. Gillespie, Richard L. Hauger, Amy J. Jak, Michael C. Neale, Xin M. Tu, Nathan Whitsel, Hong Xian, William S. Kremen, Michael J. Lyons
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- Journal:
- Psychological Medicine / Volume 52 / Issue 14 / October 2022
- Published online by Cambridge University Press:
- 30 September 2022, p. 3018
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Suicide and death by other causes among patients with a severe mental illness: cohort study comparing risks among patients discharged from inpatient care v. those treated in the community
- R. Musgrove, M. J. Carr, N. Kapur, C. A. Chew-Graham, F. Mughal, D. M. Ashcroft, R. T. Webb
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- Journal:
- Epidemiology and Psychiatric Sciences / Volume 31 / 2022
- Published online by Cambridge University Press:
- 06 May 2022, e32
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Aims
People diagnosed with a severe mental illness (SMI) are at elevated risk of dying prematurely compared to the general population. We aimed to understand the additional risk among people with SMI after discharge from inpatient psychiatric care, when many patients experience an acute phase of their illness.
MethodsIn the Clinical Practice Research Datalink (CPRD) GOLD and Aurum datasets, adults aged 18 years and older who were discharged from psychiatric inpatient care in England between 2001 and 2018 with primary diagnoses of SMI (schizophrenia, bipolar disorder, other psychoses) were matched by age and gender with up to five individuals with SMI and without recent hospital stays. Using survival analysis approaches, cumulative incidence and adjusted hazard ratios were estimated for all-cause mortality, external and natural causes of death, and suicide. All analyses were stratified by younger, middle and older ages and also by gender.
ResultsIn the year after their discharge, the risk of dying by all causes examined was higher than among individuals with SMI who had not received inpatient psychiatric care recently. Suicide risk was 11.6 times (95% CI 6.4–20.9) higher in the first 3 months and remained greater at 2–5 years after discharge (HR 2.3, 1.7–3.2). This risk elevation remained after adjustment for self-harm in the 6 months prior to the discharge date. The relative risk of dying by natural causes was raised in the first 3 months (HR 1.6, 1.3–1.9), with no evidence of elevation during the second year following discharge.
ConclusionsThere is an additional risk of death by suicide and natural causes for people with SMI who have been recently discharged from inpatient care over and above the general risk among people with the same diagnosis who have not recently been treated as an inpatient. This mortality gap shows the importance of continued focus, following discharge, on individuals who require inpatient care.
Differential drivers of intraspecific and interspecific competition during malaria–helminth co-infection
- L. F. Wait, T. Kamiya, K. J. Fairlie-Clarke, C. J. E. Metcalf, A. L. Graham, N. Mideo
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- Journal:
- Parasitology / Volume 148 / Issue 9 / August 2021
- Published online by Cambridge University Press:
- 11 May 2021, pp. 1030-1039
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Various host and parasite factors interact to determine the outcome of infection. We investigated the effects of two factors on the within-host dynamics of malaria in mice: initial infectious dose and co-infection with a helminth that limits the availability of red blood cells (RBCs). Using a statistical, time-series approach to model the within-host ‘epidemiology’ of malaria, we found that increasing initial dose reduced the time to peak cell-to-cell parasite propagation, but also reduced its magnitude, while helminth co-infection delayed peak cell-to-cell propagation, except at the highest malaria doses. Using a mechanistic model of within-host infection dynamics, we identified dose-dependence in parameters describing host responses to malaria infection and uncovered a plausible explanation of the observed differences in single vs co-infections. Specifically, in co-infections, our model predicted a higher background death rate of RBCs. However, at the highest dose, when intraspecific competition between malaria parasites would be highest, these effects of co-infection were not observed. Such interactions between initial dose and co-infection, although difficult to predict a priori, are key to understanding variation in the severity of disease experienced by hosts and could inform studies of malaria transmission dynamics in nature, where co-infection and low doses are the norm.
Effects of energy balance on appetite and physiological mediators of appetite during strenuous physical activity: secondary analysis of a randomised crossover trial
- J. Philip Karl, Adrienne Hatch-McChesney, Jillian T. Allen, Heather S. Fagnant, Patrick N. Radcliffe, Graham Finlayson, Jess A. Gwin, Lee M. Margolis, Stephen R. Hennigar, James P. McClung, Stefan M. Pasiakos
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- Journal:
- British Journal of Nutrition / Volume 126 / Issue 10 / 28 November 2021
- Published online by Cambridge University Press:
- 14 January 2021, pp. 1571-1584
- Print publication:
- 28 November 2021
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Energy deficit is common during prolonged periods of strenuous physical activity and limited sleep, but the extent to which appetite suppression contributes is unclear. The aim of this randomised crossover study was to determine the effects of energy balance on appetite and physiological mediators of appetite during a 72-h period of high physical activity energy expenditure (about 9·6 MJ/d (2300 kcal/d)) and limited sleep designed to simulate military operations (SUSOPS). Ten men consumed an energy-balanced diet while sedentary for 1 d (REST) followed by energy-balanced (BAL) and energy-deficient (DEF) controlled diets during SUSOPS. Appetite ratings, gastric emptying time (GET) and appetite-mediating hormone concentrations were measured. Energy balance was positive during BAL (18 (sd 20) %) and negative during DEF (–43 (sd 9) %). Relative to REST, hunger, desire to eat and prospective consumption ratings were all higher during DEF (26 (sd 40) %, 56 (sd 71) %, 28 (sd 34) %, respectively) and lower during BAL (–55 (sd 25) %, −52 (sd 27) %, −54 (sd 21) %, respectively; P condition < 0·05). Fullness ratings did not differ from REST during DEF, but were 65 (sd 61) % higher during BAL (P condition < 0·05). Regression analyses predicted hunger and prospective consumption would be reduced and fullness increased if energy balance was maintained during SUSOPS, and energy deficits of ≥25 % would be required to elicit increases in appetite. Between-condition differences in GET and appetite-mediating hormones identified slowed gastric emptying, increased anorexigenic hormone concentrations and decreased fasting acylated ghrelin concentrations as potential mechanisms of appetite suppression. Findings suggest that physiological responses that suppress appetite may deter energy balance from being achieved during prolonged periods of strenuous activity and limited sleep.
Associations between depression and cardiometabolic health: A 27-year longitudinal study
- Hillary L. Ditmars, Mark W. Logue, Rosemary Toomey, Ruth E. McKenzie, Carol E. Franz, Matthew S. Panizzon, Chandra A. Reynolds, Kristy N. Cuthbert, Richard Vandiver, Daniel E. Gustavson, Graham M. L. Eglit, Jeremy A. Elman, Mark Sanderson-Cimino, McKenna E. Williams, Ole A. Andreassen, Anders M. Dale, Lisa T. Eyler, Christine Fennema-Notestine, Nathan A. Gillespie, Richard L. Hauger, Amy J. Jak, Michael C. Neale, Xin M. Tu, Nathan Whitsel, Hong Xian, William S. Kremen, Michael J. Lyons
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- Psychological Medicine / Volume 52 / Issue 14 / October 2022
- Published online by Cambridge University Press:
- 12 January 2021, pp. 3007-3017
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Background
Clarifying the relationship between depression symptoms and cardiometabolic and related health could clarify risk factors and treatment targets. The objective of this study was to assess whether depression symptoms in midlife are associated with the subsequent onset of cardiometabolic health problems.
MethodsThe study sample comprised 787 male twin veterans with polygenic risk score data who participated in the Harvard Twin Study of Substance Abuse (‘baseline’) and the longitudinal Vietnam Era Twin Study of Aging (‘follow-up’). Depression symptoms were assessed at baseline [mean age 41.42 years (s.d. = 2.34)] using the Diagnostic Interview Schedule, Version III, Revised. The onset of eight cardiometabolic conditions (atrial fibrillation, diabetes, erectile dysfunction, hypercholesterolemia, hypertension, myocardial infarction, sleep apnea, and stroke) was assessed via self-reported doctor diagnosis at follow-up [mean age 67.59 years (s.d. = 2.41)].
ResultsTotal depression symptoms were longitudinally associated with incident diabetes (OR 1.29, 95% CI 1.07–1.57), erectile dysfunction (OR 1.32, 95% CI 1.10–1.59), hypercholesterolemia (OR 1.26, 95% CI 1.04–1.53), and sleep apnea (OR 1.40, 95% CI 1.13–1.74) over 27 years after controlling for age, alcohol consumption, smoking, body mass index, C-reactive protein, and polygenic risk for specific health conditions. In sensitivity analyses that excluded somatic depression symptoms, only the association with sleep apnea remained significant (OR 1.32, 95% CI 1.09–1.60).
ConclusionsA history of depression symptoms by early midlife is associated with an elevated risk for subsequent development of several self-reported health conditions. When isolated, non-somatic depression symptoms are associated with incident self-reported sleep apnea. Depression symptom history may be a predictor or marker of cardiometabolic risk over decades.
Neutron Star Extreme Matter Observatory: A kilohertz-band gravitational-wave detector in the global network
- Part of
- K. Ackley, V. B. Adya, P. Agrawal, P. Altin, G. Ashton, M. Bailes, E. Baltinas, A. Barbuio, D. Beniwal, C. Blair, D. Blair, G. N. Bolingbroke, V. Bossilkov, S. Shachar Boublil, D. D. Brown, B. J. Burridge, J. Calderon Bustillo, J. Cameron, H. Tuong Cao, J. B. Carlin, S. Chang, P. Charlton, C. Chatterjee, D. Chattopadhyay, X. Chen, J. Chi, J. Chow, Q. Chu, A. Ciobanu, T. Clarke, P. Clearwater, J. Cooke, D. Coward, H. Crisp, R. J. Dattatri, A. T. Deller, D. A. Dobie, L. Dunn, P. J. Easter, J. Eichholz, R. Evans, C. Flynn, G. Foran, P. Forsyth, Y. Gai, S. Galaudage, D. K. Galloway, B. Gendre, B. Goncharov, S. Goode, D. Gozzard, B. Grace, A. W. Graham, A. Heger, F. Hernandez Vivanco, R. Hirai, N. A. Holland, Z. J. Holmes, E. Howard, E. Howell, G. Howitt, M. T. Hübner, J. Hurley, C. Ingram, V. Jaberian Hamedan, K. Jenner, L. Ju, D. P. Kapasi, T. Kaur, N. Kijbunchoo, M. Kovalam, R. Kumar Choudhary, P. D. Lasky, M. Y. M. Lau, J. Leung, J. Liu, K. Loh, A. Mailvagan, I. Mandel, J. J. McCann, D. E. McClelland, K. McKenzie, D. McManus, T. McRae, A. Melatos, P. Meyers, H. Middleton, M. T. Miles, M. Millhouse, Y. Lun Mong, B. Mueller, J. Munch, J. Musiov, S. Muusse, R. S. Nathan, Y. Naveh, C. Neijssel, B. Neil, S. W. S. Ng, V. Oloworaran, D. J. Ottaway, M. Page, J. Pan, M. Pathak, E. Payne, J. Powell, J. Pritchard, E. Puckridge, A. Raidani, V. Rallabhandi, D. Reardon, J. A. Riley, L. Roberts, I. M. Romero-Shaw, T. J. Roocke, G. Rowell, N. Sahu, N. Sarin, L. Sarre, H. Sattari, M. Schiworski, S. M. Scott, R. Sengar, D. Shaddock, R. Shannon, J. SHI, P. Sibley, B. J. J. Slagmolen, T. Slaven-Blair, R. J. E. Smith, J. Spollard, L. Steed, L. Strang, H. Sun, A. Sunderland, S. Suvorova, C. Talbot, E. Thrane, D. Töyrä, P. Trahanas, A. Vajpeyi, J. V. van Heijningen, A. F. Vargas, P. J. Veitch, A. Vigna-Gomez, A. Wade, K. Walker, Z. Wang, R. L. Ward, K. Ward, S. Webb, L. Wen, K. Wette, R. Wilcox, J. Winterflood, C. Wolf, B. Wu, M. Jet Yap, Z. You, H. Yu, J. Zhang, J. Zhang, C. Zhao, X. Zhu
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- Journal:
- Publications of the Astronomical Society of Australia / Volume 37 / 2020
- Published online by Cambridge University Press:
- 05 November 2020, e047
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Gravitational waves from coalescing neutron stars encode information about nuclear matter at extreme densities, inaccessible by laboratory experiments. The late inspiral is influenced by the presence of tides, which depend on the neutron star equation of state. Neutron star mergers are expected to often produce rapidly rotating remnant neutron stars that emit gravitational waves. These will provide clues to the extremely hot post-merger environment. This signature of nuclear matter in gravitational waves contains most information in the 2–4 kHz frequency band, which is outside of the most sensitive band of current detectors. We present the design concept and science case for a Neutron Star Extreme Matter Observatory (NEMO): a gravitational-wave interferometer optimised to study nuclear physics with merging neutron stars. The concept uses high-circulating laser power, quantum squeezing, and a detector topology specifically designed to achieve the high-frequency sensitivity necessary to probe nuclear matter using gravitational waves. Above 1 kHz, the proposed strain sensitivity is comparable to full third-generation detectors at a fraction of the cost. Such sensitivity changes expected event rates for detection of post-merger remnants from approximately one per few decades with two A+ detectors to a few per year and potentially allow for the first gravitational-wave observations of supernovae, isolated neutron stars, and other exotica.
LO49: Digital technology distraction for acute pain in children: a meta-analysis
- M. Gates, L. Hartling, J. Shulhan-Kilroy, T. MacGregor, S. Guitard, A. Wingert, R. Featherstone, B. Vandermeer, N. Poonai, J. Kircher, S. Perry, T. Graham, S. Scott, S. Ali
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- Journal:
- Canadian Journal of Emergency Medicine / Volume 22 / Issue S1 / May 2020
- Published online by Cambridge University Press:
- 13 May 2020, p. S25
- Print publication:
- May 2020
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Introduction: Digital distraction is being integrated into pediatric pain care, but its efficacy is currently unknown. We conducted a systematic review to determine the effect of digital technology distraction on pain and distress for children experiencing acutely painful conditions or medical procedures. Methods: We searched eight online databases (MEDLINE, Embase, Cochrane Library, CINAHL, PsycINFO, IEEE Xplore, Ei Compendex, Web of Science), grey literature sources, scanned reference lists, and contacted experts for quantitative studies where digital technologies were used as distraction for acutely painful conditions or procedures in children. Study selection was performed by two independent reviewers with consensus. One reviewer extracted relevant study data and another verified it for accuracy. Appraisal of risk of bias within studies and the certainty of the body of evidence were performed independently in duplicate, with the final appraisal determined by consensus. The primary outcomes of interest were child pain and distress. Results: Of 3247 unique records identified by the search, we included 106 studies (n = 7820) that reported on digital technology distractors (e.g., virtual reality; videogames) used during common procedures (e.g., venipuncture, minor dental procedures, burn treatments). We located no studies reporting on painful conditions. For painful procedures, digital distraction resulted in a modest but clinically important reduction in self-reported pain (SMD -0.48, 95% CI -0.66 to -0.29, 46 RCTs, n = 3200), observer-reported pain (SMD -0.68, 95% CI -0.91 to -0.45, 17 RCTs, n = 1199), behavioural pain (SMD -0.57, 95% CI -0.94 to -0.19, 19 RCTs, n = 1173), self-reported distress (SMD -0.49, 95% CI -0.70 to -0.27, 19 RCTs, n = 1818), observer-reported distress (SMD -0.47, 95% CI -0.77 to -0.17, 10 RCTs, n = 826), and behavioural distress (SMD -0.35, 95% CI -0.59 to -0.12, 17 RCTs, n = 1264) compared to usual care. Few studies directly compared different distractors or provided subgroup data to inform applicability. Conclusion: Digital distraction provides modest pain and distress reduction for children undergoing painful procedures; its superiority over non-digital distractors is not established. Healthcare providers and parents should strongly consider using distractions as a pain-reduction strategy for children and teens during common painful procedures (e.g., needle pokes, dental fillings). Context, child preference, and availability should inform the choice of distractor.
Chapter 2 - The Intertidal Zone of the North-East Atlantic Region
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- By Stephen J. Hawkins, Kathryn E. Pack, Louise B. Firth, Nova Mieszkowska, Ally J. Evans, Gustavo M. Martins, Per Åberg, Leoni C. Adams, Francisco Arenas, Diana M. Boaventura, Katrin Bohn, C. Debora G. Borges, João J. Castro, Ross A. Coleman, Tasman P. Crowe, Teresa Cruz, Mark S. Davies, Graham Epstein, João Faria, João G. Ferreira, Natalie J. Frost, John N. Griffin, ME Hanley, Roger J. H. Herbert, Kieran Hyder, Mark P. Johnson, Fernando P. Lima, Patricia Masterson-Algar, Pippa J. Moore, Paula S. Moschella, Gillian M. Notman, Federica G. Pannacciulli, Pedro A. Ribeiro, Antonio M. Santos, Ana C. F. Silva, Martin W. Skov, Heather Sugden, Maria Vale, Kringpaka Wangkulangkul, Edward J. G. Wort, Richard C. Thompson, Richard G. Hartnoll, Michael T. Burrows, Stuart R. Jenkins
- Edited by Stephen J. Hawkins, Marine Biological Association of the United Kingdom, Plymouth, Katrin Bohn, Louise B. Firth, University of Plymouth, Gray A. Williams, The University of Hong Kong
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- Interactions in the Marine Benthos
- Published online:
- 07 September 2019
- Print publication:
- 29 August 2019, pp 7-46
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Summary
The rocky shores of the north-east Atlantic have been long studied. Our focus is from Gibraltar to Norway plus the Azores and Iceland. Phylogeographic processes shape biogeographic patterns of biodiversity. Long-term and broadscale studies have shown the responses of biota to past climate fluctuations and more recent anthropogenic climate change. Inter- and intra-specific species interactions along sharp local environmental gradients shape distributions and community structure and hence ecosystem functioning. Shifts in domination by fucoids in shelter to barnacles/mussels in exposure are mediated by grazing by patellid limpets. Further south fucoids become increasingly rare, with species disappearing or restricted to estuarine refuges, caused by greater desiccation and grazing pressure. Mesoscale processes influence bottom-up nutrient forcing and larval supply, hence affecting species abundance and distribution, and can be proximate factors setting range edges (e.g., the English Channel, the Iberian Peninsula). Impacts of invasive non-native species are reviewed. Knowledge gaps such as the work on rockpools and host–parasite dynamics are also outlined.
LO63: Humanoid robot-based distraction to reduce pain and distress during venipuncture in the pediatric emergency department: A randomized controlled trial
- S. Ali, R. Manaloor, K. Ma, M. Sivakumar, B. Vandermeer, T. Beran, S. Scott, T. Graham, S. Curtis, H. Jou, N. Beirnes, L. Hartling
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- Journal:
- Canadian Journal of Emergency Medicine / Volume 21 / Issue S1 / May 2019
- Published online by Cambridge University Press:
- 02 May 2019, pp. S30-S31
- Print publication:
- May 2019
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Introduction: Intravenous insertion (IVI) is identified by children as extremely painful and the resultant distress can have lasting negative consequences. There is an urgent need to effectively manage such procedures. Our primary objective was to compare the pain and distress of IVI with the addition of humanoid robot-based distraction to standard care, versus standard care alone. Methods: This two-armed randomized controlled trial (RCT) was conducted from April 2017 to May 2018 at the Stollery Children's Hospital emergency department (ED). Children aged 6 to 11 years who required IVI were included. Exclusion criteria included hearing or visual impairments, neurocognitive delays, sensory impairment to pain, previous enrolment, and discretion of the ED clinical staff. Primary outcomes were measured using the Observational Scale of Behavioural Distress-Revised (OSBD-R) (distress) and the Faces Pain Scale-Revised (FPS-R) (pain). A total of 426 pediatric patients were screened and 340 were excluded. Results: We recruited 86 children, of which 55% (47/86) were male; 9% (7/82) were premature at birth; 82% (67/82) had a previous ED visit; 30% (25/82) required previous hospitalization; 78% (64/82) had previous IV placement and 96% (78/81) received topical anesthesia. The mean total OSBD-R score was 1.49 ± 2.36 (standard care) compared to 0.78 ± 1.32 (robot group) (p = 0.047). The median FPS-R during the IV procedure was 4 (IQR 2,6) in the standard care group alone, compared to 2 (IQR 0,4) with the addition of humanoid robot-based distraction (p = 0.10). Change in parental state anxiety pre-procedure versus post-procedure was not significantly different between groups (p = 0.49). Parental satisfaction with the IV start was 93% (39/42) in the robot arm compared to 74% (29/39) in the standard care arm (p = 0.03). Parents were also more satisfied with management of their child's pain in the robot group (95% very satisfied) compared with standard care (72% very satisfied) (p = 0.002). Conclusion: A statistically significant reduction in distress was observed with the addition of robot-based distraction to standard care. Humanoid robot-based distraction therapy reduces distress and to a lesser extent, pain, in children undergoing IVI in the ED. Further trials are required to confirm utility in other age groups and settings.
LO35: Characterizing pain in children with acute gastroenteritis presenting to the emergency department
- S. Ali, C. Maki, J. Xie, B. Lee, T. Graham, O. Vanderkooi, S. MacDonald, N. Poonai, J. Thull-Freedman, M. Rajagopal, N. Dow, M. Sivakumar, S. Freedman, Alberta Provincial Pediatric EnTeric Infection TEam (APPETITE), Pediatric Emergency Research Canada (PERC)
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- Journal:
- Canadian Journal of Emergency Medicine / Volume 21 / Issue S1 / May 2019
- Published online by Cambridge University Press:
- 02 May 2019, pp. S19-S20
- Print publication:
- May 2019
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Introduction: Although acute gastroenteritis is an extremely common childhood illness, there is a paucity of literature characterizing the associated pain and its management. Our primary objective was to quantify the pain experienced by children with acute gastroenteritis in the 24-hours prior to emergency department (ED) presentation. Secondary objectives included describing maximum pain, analgesic use, discharge recommendations, and factors that influenced analgesic use in the ED. Methods: Study participants were recruited into this prospective cohort study by the Alberta Provincial Pediatric EnTeric Infection TEam between January 2014 and September 2017. This study was conducted at two Canadian pediatric EDs; the Alberta Children's Hospital (Calgary) and the Stollery Children's Hospital (Edmonton). Eligibility criteria included < 18 years of age, acute gastroenteritis (□ 3 episodes of diarrhea or vomiting in the previous 24 hours), and symptom duration □ 7 days. The primary study outcome, caregiver-reported maximum pain in the 24-hours prior to presentation, was assessed using the 11-point Verbal Numerical Rating Scale. Results: We recruited 2136 patients, median age 20.8 months (IQR 10.4, 47.4); 45.8% (979/2136) female. In the 24-hours prior to enrolment, 28.6% (610/2136) of caregivers reported that their child experienced moderate (4-6) and 46.2% (986/2136) severe (7-10) pain in the preceding 24-hours. During the emergency visit, 31.1% (664/2136) described pain as moderate and 26.7% (571/2136) as severe. In the ED, analgesia was provided to 21.2% (452/2131) of children. The most commonly administered analgesics in the ED were ibuprofen (68.1%, 308/452) and acetaminophen (43.4%, 196/452); at home, acetaminophen was most commonly administered (77.7%, 700/901), followed by ibuprofen (37.5%, 338/901). Factors associated with analgesia use in the ED were greater pain scores during the visit, having a primary-care physician, shorter illness duration, fewer diarrheal episodes, presence of fever and hospitalization. Conclusion: Although children presenting to the ED with acute gastroenteritis experience moderate to severe pain, both prior to and during their emergency visit, analgesic use is limited. Future research should focus on appropriate pain management through the development of effective and safe pain treatment plans.
Plagioclase-rich microgranular inclusions from the late-Caledonian Galway Granite, Connemara, Ireland
- N. T. Graham, M. Feely, B. Callaghan
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- Mineralogical Magazine / Volume 64 / Issue 1 / February 2000
- Published online by Cambridge University Press:
- 25 June 2018, pp. 113-120
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We report on the occurrence, petrology and geochemistry of recently recognized leucocratic plagioclase-rich microgranular inclusions hosted by two granite facies in the late-Caledonian Galway Granite, Connemara, Ireland. They have been recorded at 66 localities along an ESE trending, 4 km wide corridor which incorporates the contact zone between their host granites (i.e. The Megacrystic Granite and the Mingling and Mixing Zone Granodiorite). The inclusions are discoidal in shape and oriented parallel to the general ESE trending foliation in the granites with the most elongate (6.0 × 0.6 cm) occurring in zones of strongest fabric intensity. Contacts between the inclusions and the host granite are sharp with no chilled margin visible. They display a fine-grained (<1 mm) interlocking texture with occasional crystals of plagioclase ranging up to 2 mm in length. Microprobe analysis shows that the plagioclase is essentially oligoclase (An22–32) in composition and is similar to that (i.e. An21–30) occurring in the host granites. Furthermore, the oligoclase accounts for between 61 and 78% of the mode which is reflected in the major element chemistry of the inclusions. Other minerals (in decending order of abundance) include K-feldspar, quartz, biotite and magnetite. The origin of the inclusions is unclear. However, the results of the microprobe analysis provide evidence of a link between them and their host granites.
LO87: iPad distraction during intravenous cannulation in the pediatric emergency department: a randomized clinical trial
- K. Ma, S. Ali, N. Dow, B. Vandermeer, A. Issawi, S. Scott Kin, T. Beran, T. A.D. Graham, S. Curtis, H. Jou, L. Hartling
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- Journal:
- Canadian Journal of Emergency Medicine / Volume 20 / Issue S1 / May 2018
- Published online by Cambridge University Press:
- 11 May 2018, p. S38
- Print publication:
- May 2018
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Introduction: Intravenous (IV) cannulation is commonly performed in emergency departments (ED), often causing substantial pain and distress. Distraction has been shown to reduce child-reported pain, but there is currently little published about the effects of using iPad technology as a distraction tool. Our primary objective was to compare the reduction of pain and distress using iPad distraction (games, movies, books of the child’s choice) in addition to standard care, versus standard care alone. Methods: This randomized clinical trial, conducted at the Stollery Childrens Hospital ED, recruited children between ages 6 to 11 years requiring IV cannulation. Study arm assignment was performed using REDCaps randomization feature. Due to the nature of the intervention, blinding was not possible for the children, parents or research and ED staff, but the data analyst was blinded to intervention assignment until completion of analysis. Pain, distress, and parental anxiety were measured using the Faces Pain Scale-Revised, the Observed Scale of Behavioural Distress-Revised, and the State Trait Anxiety Inventory, respectively. The pain scores and observed behavioural distress scores were compared using the Mann-Whitney U test. Other co-variates were analyzed using a linear regression analysis. Results: A total of 85 children were enrolled, with 42 receiving iPad distraction and 43 standard care, of which 40 (95%) and 35 (81%) children received topical anesthesia, respectively (p=0.09). There were 40 girls (47.1%) with a mean age of 8.32 +/− 1.61 years. The pain scores during IV cannulation (p=0.35) and the change in pain score during the procedure compared to baseline (p=0.79) were not significantly different between the groups, nor were the observed distress scores during IV cannulation (p=0.09), or the change in observed distress during the procedure compared to baseline (p=0.44). A regression analysis showed children in both groups had greater total behavioural stress if it was their first ED visit (p=0.01), had prior hospitalization experience (p=0.04) or were admitted to hospital during this visit (p=0.007). A previous ED visit, however, was predictive of a greater increase in parental anxiety from baseline (p=0.02). When parents were asked whether they would use the same methods to manage pain for their child, parents of the iPad group were more likely to say yes than were parents of the standard care group (p=0.03). Conclusion: iPad distraction during IV cannulation in school-aged children was not found to decrease pain or distress more than standard care alone, but parents preferred its use. The effects of iPad distraction may have been over-shadowed by potent topical anesthetic effect. Future directions include exploring iPad distraction for other age groups, and studying novel technology such as virtual reality and interactive humanoid robots.
MP09: Canadian Community Utilization of Stroke Prevention Pilot Study-Emergency Department (C-CUSP ED)
- R. Parkash, K. Magee, M. McMullen, M.B. Clory, M. D’Astous, M. Robichaud, G. Andolfatto, B. Read, J. Wang, L. Thabane, C.L. Atzema, P. Dorian, J. Kaczorowski, D. Banner, R. Nieuwlaat, N. Ivers, T. Huynh, J. Curran, I. Graham, S.J. Connolly, J.S. Healey
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- Journal:
- Canadian Journal of Emergency Medicine / Volume 19 / Issue S1 / May 2017
- Published online by Cambridge University Press:
- 15 May 2017, p. S68
- Print publication:
- May 2017
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Introduction: Atrial fibrillation (AF) is the most common sustained arrhythmia affecting 1-2% of the population. Oral anticoagulation (OAC) reduces stroke risk by 60-80% in AF patients, but only 50% of indicated patients receive OAC. Many patients present to the ED with AF due to arrhythmia symptoms, however; lack of OAC prescription in the ED has been identified as a significant gap in the care of AF patients. Methods: This was a multi-center, pragmatic, three-phase before-after study, in three Canadian sites. Patients who presented to the ED with electrocardiographically (ECG) documented, nonvalvular AF and were discharged home were included. Phase 1 was a retrospective chart review to determine OAC prescription of AF patients in each ED; Phase 2 was a low-intensity knowledge translation intervention where a simple OAC-prescription tool for ED physicians with subsequent short-term OAC prescription was used, as well as an AF patient education package and a letter to family physicians; phase 3 incorporated Phase 2 interventions, but added immediate follow-up in a community AF clinic. The primary outcome of the study was the rate of new OAC prescriptions at ED discharge in AF patients who were OAC eligible and were not on OAC at presentation. Results: A total of 632 patients were included from June, 2015-November, 2016. ED census ranged from 30000-68000 annual visits. Mean age was 71±15, 67±12, 67±13 years, respectively. 47.5% were women, most responsible ED diagnosis was AF in 75.8%. The mean CHA2DS2-VASc score was 2.6±1.8, with no difference amongst groups. There were 266 patients eligible for OAC and were not on this at presentation. In this group, the prescription of new OAC was 15.8% in Phase 1 as compared to 54% and 47%, in Phases 2 and 3, respectively. After adjustment for center, components of the CHA2DS2-VASc score, prior risk of bleeding and most responsible ED diagnosis, the odds ratio for new OAC prescription was 8.0 (95%CI (3.5,18.3) p<0.001) for Phase 3 vs 1, and 10.0 (95%CI (4.4,22.9) p<0.001), for Phase 2 vs 1). No difference in OAC prescription was seen between Phases 2 and 3. Conclusion: Use of a simple OAC-prescription tool was associated with an increase in new OAC prescription in the ED for eligible patients with AF. Further testing in a rigorous study design to assess the effect of this practice on stroke prevention in the AF patients who present to the ED is indicated.
Turbulence Heating ObserveR – satellite mission proposal
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- A. Vaivads, A. Retinò, J. Soucek, Yu. V. Khotyaintsev, F. Valentini, C. P. Escoubet, O. Alexandrova, M. André, S. D. Bale, M. Balikhin, D. Burgess, E. Camporeale, D. Caprioli, C. H. K. Chen, E. Clacey, C. M. Cully, J. De Keyser, J. P. Eastwood, A. N. Fazakerley, S. Eriksson, M. L. Goldstein, D. B. Graham, S. Haaland, M. Hoshino, H. Ji, H. Karimabadi, H. Kucharek, B. Lavraud, F. Marcucci, W. H. Matthaeus, T. E. Moore, R. Nakamura, Y. Narita, Z. Nemecek, C. Norgren, H. Opgenoorth, M. Palmroth, D. Perrone, J.-L. Pinçon, P. Rathsman, H. Rothkaehl, F. Sahraoui, S. Servidio, L. Sorriso-Valvo, R. Vainio, Z. Vörös, R. F. Wimmer-Schweingruber
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- Journal:
- Journal of Plasma Physics / Volume 82 / Issue 5 / October 2016
- Published online by Cambridge University Press:
- 22 September 2016, 905820501
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The Universe is permeated by hot, turbulent, magnetized plasmas. Turbulent plasma is a major constituent of active galactic nuclei, supernova remnants, the intergalactic and interstellar medium, the solar corona, the solar wind and the Earth’s magnetosphere, just to mention a few examples. Energy dissipation of turbulent fluctuations plays a key role in plasma heating and energization, yet we still do not understand the underlying physical mechanisms involved.
THOR is a mission designed to answer the questions of how turbulent plasma is heated and particles accelerated, how the dissipated energy is partitioned and how dissipation operates in different regimes of turbulence.THOR is a single-spacecraft mission with an orbit tuned to maximize data return from regions in near-Earth space – magnetosheath, shock, foreshock and pristine solar wind – featuring different kinds of turbulence. Here we summarize theTHOR proposal submitted on 15 January 2015 to the ‘Call for a Medium-size mission opportunity in ESAs Science Programme for a launch in 2025 (M4)’.THOR has been selected by European Space Agency (ESA) for the study phase.
Exposure to viral and bacterial pathogens among Soay sheep (Ovis aries) of the St Kilda archipelago
- A. L. GRAHAM, D. H. NUSSEY, J. O. LLOYD-SMITH, D. LONGBOTTOM, M. MALEY, J. M. PEMBERTON, J. G. PILKINGTON, K. C. PRAGER, L. SMITH, K. A. WATT, K. WILSON, T. N. McNEILLY, F. BRÜLISAUER
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- Journal:
- Epidemiology & Infection / Volume 144 / Issue 9 / July 2016
- Published online by Cambridge University Press:
- 01 February 2016, pp. 1879-1888
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We assessed evidence of exposure to viruses and bacteria in an unmanaged and long-isolated population of Soay sheep (Ovis aries) inhabiting Hirta, in the St Kilda archipelago, 65 km west of Benbecula in the Outer Hebrides of Scotland. The sheep harbour many metazoan and protozoan parasites but their exposure to viral and bacterial pathogens is unknown. We tested for herpes viral DNA in leucocytes and found that 21 of 42 tested sheep were infected with ovine herpesvirus 2 (OHV-2). We also tested 750 plasma samples collected between 1997 and 2010 for evidence of exposure to seven other viral and bacterial agents common in domestic Scottish sheep. We found evidence of exposure to Leptospira spp., with overall seroprevalence of 6·5%. However, serological evidence indicated that the population had not been exposed to border disease, parainfluenza, maedi-visna, or orf viruses, nor to Chlamydia abortus. Some sheep tested positive for antibodies against Mycobacterium avium subsp. paratuberculosis (MAP) but, in the absence of retrospective faecal samples, the presence of this infection could not be confirmed. The roles of importation, the pathogen–host interaction, nematode co-infection and local transmission warrant future investigation, to elucidate the transmission ecology and fitness effects of the few viral and bacterial pathogens on Hirta.
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies
- S. Clement, O. Schauman, T. Graham, F. Maggioni, S. Evans-Lacko, N. Bezborodovs, C. Morgan, N. Rüsch, J. S. L. Brown, G. Thornicroft
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- Journal:
- Psychological Medicine / Volume 45 / Issue 1 / January 2015
- Published online by Cambridge University Press:
- 21 February 2014, pp. 11-27
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Background
Individuals often avoid or delay seeking professional help for mental health problems. Stigma may be a key deterrent to help-seeking but this has not been reviewed systematically. Our systematic review addressed the overarching question: What is the impact of mental health-related stigma on help-seeking for mental health problems? Subquestions were: (a) What is the size and direction of any association between stigma and help-seeking? (b) To what extent is stigma identified as a barrier to help-seeking? (c) What processes underlie the relationship between stigma and help-seeking? (d) Are there population groups for which stigma disproportionately deters help-seeking?
MethodFive electronic databases were searched from 1980 to 2011 and references of reviews checked. A meta-synthesis of quantitative and qualitative studies, comprising three parallel narrative syntheses and subgroup analyses, was conducted.
ResultsThe review identified 144 studies with 90 189 participants meeting inclusion criteria. The median association between stigma and help-seeking was d = − 0.27, with internalized and treatment stigma being most often associated with reduced help-seeking. Stigma was the fourth highest ranked barrier to help-seeking, with disclosure concerns the most commonly reported stigma barrier. A detailed conceptual model was derived that describes the processes contributing to, and counteracting, the deterrent effect of stigma on help-seeking. Ethnic minorities, youth, men and those in military and health professions were disproportionately deterred by stigma.
ConclusionsStigma has a small- to moderate-sized negative effect on help-seeking. Review findings can be used to help inform the design of interventions to increase help-seeking.
Rates of diagnostic transition and cognitive change at 18-month follow-up among 1,112 participants in the Australian Imaging, Biomarkers and Lifestyle Flagship Study of Ageing (AIBL)
- Kathryn A. Ellis, Cassandra Szoeke, Ashley I. Bush, David Darby, Petra L. Graham, Nicola T. Lautenschlager, S. Lance Macaulay, Ralph N. Martins, Paul Maruff, Colin L. Masters, Simon J. McBride, Kerryn E. Pike, Stephanie R. Rainey-Smith, Alan Rembach, Joanne Robertson, Christopher C. Rowe, Greg Savage, Victor L. Villemagne, Michael Woodward, William Wilson, Ping Zhang, David Ames, the AIBL Research Group
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- International Psychogeriatrics / Volume 26 / Issue 4 / April 2014
- Published online by Cambridge University Press:
- 20 November 2013, pp. 543-554
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Background:
The Australian Imaging, Biomarkers and Lifestyle (AIBL) Flagship Study of Ageing is a prospective study of 1,112 individuals (211 with Alzheimer's disease (AD), 133 with mild cognitive impairment (MCI), and 768 healthy controls (HCs)). Here we report diagnostic and cognitive findings at the first (18-month) follow-up of the cohort. The first aim was to compute rates of transition from HC to MCI, and MCI to AD. The second aim was to characterize the cognitive profiles of individuals who transitioned to a more severe disease stage compared with those who did not.
Methods:Eighteen months after baseline, participants underwent comprehensive cognitive testing and diagnostic review, provided an 80 ml blood sample, and completed health and lifestyle questionnaires. A subgroup also underwent amyloid PET and MRI neuroimaging.
Results:The diagnostic status of 89.9% of the cohorts was determined (972 were reassessed, 28 had died, and 112 did not return for reassessment). The 18-month cohort comprised 692 HCs, 82 MCI cases, 197 AD patients, and one Parkinson's disease dementia case. The transition rate from HC to MCI was 2.5%, and cognitive decline in HCs who transitioned to MCI was greatest in memory and naming domains compared to HCs who remained stable. The transition rate from MCI to AD was 30.5%.
Conclusion:There was a high retention rate after 18 months. Rates of transition from healthy aging to MCI, and MCI to AD, were consistent with established estimates. Follow-up of this cohort over longer periods will elucidate robust predictors of future cognitive decline.
Socioeconomic disadvantage and psychotherapy
- Graham N. Meadows, Andre T. Tylee
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- Journal:
- The British Journal of Psychiatry / Volume 202 / Issue 2 / February 2013
- Published online by Cambridge University Press:
- 02 January 2018, pp. 86-88
- Print publication:
- February 2013
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In this edition of the Journal, findings presented by Jokela and colleagues suggest some improvements in the equity of service provision of psychotherapies in the UK. This is encouraging, however, further work would be necessary to exclude other forms of inequity. For instance, people with equivalent need in different areas might find their needs are responded to with different durations of treatment.
Contributors
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- By Nozomi Akanuma, Gonzalo Alarcón, R. Arunachalam, Sarah H. Bernard, Frank M. C. Besag, Istvan Bodi, Stephen Brown, Franz Brunnhuber, Antonella Cerquiglini, J. Helen Cross, R. Shane Delamont, Archana Desurkar, Lee Drummond, Rona Eade, Robert D. C. Elwes, Bidi Evans, Peter Fenwick, Colin D. Ferrie, Paul L. Furlong, Laura H. Goldstein, Sally Gomersall, Sushma Goyal, Jane Hanna, Yvonne Hart, Dominic C. Heaney, Graham E. Holder, Mrinalini Honavar, Elaine Hughes, Jozef M. Jarosz, John G. R. Jefferys, Jane Juler, Mathias Koepp, Michalis Koutroumanidis, Maureen Lahiff, Louis Lemieux, David McCormick, Brian Meldrum, John D. C. Mellers, Nicholas Moran, John Moriarty, Robin G. Morris, Nandini Mullatti, Lina Nashef, Jennifer Nightingale, T. J. von Oertzen, Corina O'Neill, Philip N. Patsalos, Stella Pearson, Charles E. Polkey, Ronit Pressler, Edward H. Reynolds, Mark P. Richardson, Leone Ridsdale, Robert Robinson, Greg Rogers, Euan M. Ross, Richard P. Selway, Stefano Seri, Simeran Sharma, Graeme J. Sills, Andrew Simmons, Shiri Spector, Mark Stevenson, Jade N. Thai, Brian Toone, Antonio Valentín, Nuria T. Villagra, Matthew Walker, William Whitehouse
- Edited by Gonzalo Alarcón, King's College London, Antonio Valentín, King's College London
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- Introduction to Epilepsy
- Published online:
- 05 July 2012
- Print publication:
- 26 April 2012, pp xii-xv
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