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High rates of psychiatric comorbidities have been found in people with problem gambling (PBG), including substance use, anxiety, and mood disorders. Psychotic disorders have received less attention, although this comorbidity is expected to have a significant impact on the course, consequences, and treatment of PBG. This review aimed to estimate the prevalence of psychotic disorders in PBG.
Methods
Medline (Ovid), EMBASE, PsycINFO (Ovid), CINAHL, CENTRAL, Web of Science, and ProQuest were searched on November 1, 2023, without language restrictions. Studies involving people with PBG and reporting the prevalence of schizophrenia spectrum and other psychotic disorders were included. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal checklist for systematic reviews of prevalence data. The pooled prevalence of psychotic disorders was calculated using a random effects generalized linear mixed model and presented with forest plots.
Results
Of 1,271 records screened, 22 studies (n = 19,131) were included. The overall prevalence of psychotic disorders was 4.9% (95% CI, 3.6–6.5%, I2 = 88%). A lower prevalence was found in surveyed/recruited populations, compared with treatment-seeking individuals and register-based studies. No differences were found for factors such as treatment setting (inpatient/outpatient), diagnoses of psychotic disorders (schizophrenia only/other psychotic disorders), and assessment time frame (current/lifetime). The majority of included studies had a moderate risk of bias.
Conclusions
These findings highlight the relevance of screening problem gamblers for schizophrenia spectrum and other psychotic disorders, as well as any other comorbid mental health conditions, given the significant impact such comorbidities can have on the recovery process.
The Maramures Basin, in the Carpathian mountain belt of northern Romania on the border with the Ukraine, belongs to the eastern part of the Pannonian Basin. In the study area, extensional tectonic movements during the Miocene were coeval with silicic and intermediate volcanism in the inner part of the Eastern Carpathians. Throughout this region, explosive events have resulted in the deposition of pyroclastic flows and ash-fall deposits interbedded with marine sediments.
Several tuff units of Badenian (15–13.6 Ma) age occurring throughout the area are extensively zeolitized. These rocks occur as massive homogeneous beds, white to pale greenish-blue, and are commonly extensively jointed. In the Bârsana-Calinesti area and along the Morii Valley, two conspicuous tuff units that can be traced over many km are separated by a calcareous sandstone bed. Most tuffs have a vitroclastic texture in which former glass shards are pseudomorphed by clay minerals and clinoptilolite. Opal-CT commonly occurs as clumps of radiating rods that produce a spherical morphology. Also, rare celadonite is found in the lower greenish tuffs. Pyrogenic crystal fragments are quartz, plagioclase and biotite. Folded muscovite plates and fragments of basement rocks are dominant among the lithic clasts. Above the Bârsana Formation, a second series of white zeolitized tuff, the Ocna Sugatag Formation, is represented by at least two different units overlying an evaporite salt deposit. A large outcrop of a massive white tuff at this locality contains abundant fine-grained clinoptilolite and cation-exchange capacity values of >160 meq/100 g. Clinoptilolite-Ca is also present in the Sighetu tuff unit in the northern part of the Maramures Basin where a distinctive horizon contains plant remains preserved in spherical concretions. Plant material and algal limestones in the same succession strongly suggest that the marine depositional environment was close inshore, and shallow-rather than deep-water conditions are inferred. A mineralogically similar, unaltered, volcanic tuff found in the Coas area suggests that the precursor glass was rhyolitic (72–74% SiO2) with a high-K calc-alkaline affinity. We conclude that pervasive zeolitization is due to the interaction between seawater and vitroclasts at an early stage after deposition.
The Early to Middle Pleistocene Transition (EMPT) is characterised by major environmental changes and evolutionary innovations within the genus Homo but the scarcity of the African EMPT fossil and archaeological records obscures its palaeoecological context. Here, we present archaeological and faunal evidence from a newly excavated West-Turkana EMPT site—Kanyimangin.
In this article, we study how political parties located on the right of the political spectrum adapt to changing electoral and political constraints. Drawing on the concept of policy feedback, we turn to the politics of social policy in the province of Quebec to show that the Coalition Avenir Québec (CAQ), a right-wing party, embraced a more centrist strategy than the preferences of its electoral base would suggest. The CAQ has rejected the austerity policies associated with the previous government and has favoured social policy expansion rather than tax cuts or a quicker return to balanced budgets. We then explore the reasons for this move toward the centre. Our evidence suggests that self-reinforcing feedback effects from existing policies shape public opinion and electoral strategies, which contribute to moderating the actions of this right-wing governing party.
To determine the factors associated with the nutritional status of children under 5 years of age in Guinea between 2005 and 2018.
Design:
Data from the 2005, 2012 and 2018 Guinea Demographic and Health Surveys (DHS) were used for this study. Three anthropometric indicators (stunting, underweight and wasting) were assessed according to the 2006 WHO Child Growth Standards and analysed according to the year, the characteristics of the household, the child and the mother using multivariate logistic regression.
Setting:
Data were collected in the capital Conakry and in the seven administrative regions of Guinea.
Participants:
The study included children under 5 years of age for whom height and weight were available: 2765 (DHS-2005), 3220 (DHS-2012) and 3551 (DHS-2018).
Results:
Analysis of the data from the three surveys showed that children living in rural areas were more likely to be stunted than children living in urban areas (OR = 1·32, 95 % CI (1·08, 1·62)). Similarly, the children from middle, poor and the poorest households were more likely to be stunted and underweight than children from richest households. The chance to stunting increased with age in the first 3 years. However, the chance to wasting decreased with age. Children in all age groups were more likely of being underweight. Children of thin mothers were more likely to be both wasted (OR = 2·0, 95 % CI (1·5, 2·6)) and underweight (OR = 1·9, 95 % CI (1·5, 2·3)).
Conclusion:
The implementation of targeted interventions adapted to the observed disparities could considerably improve the nutritional status of children and mothers.
Public choice theory suggests that citizens have a deficit bias: they approve governments for running large deficits that increase spending or reduce taxes. In contrast, others contend that citizens reward governments for balanced budgets. We contribute to this debate by modelling a popularity function for the Canadian federal government and show that the impact of fiscal policies on the executive's popularity changes over time. Until the early 1990s, Canadians preferred budget deficits. As deficits became unsustainable during the economic crisis of the early 1990s, the government shifted its fiscal policy paradigm, as balancing the budget became its primary fiscal objective and citizens were actively concerned about the deficits. Since 1993, citizens’ deficit bias morphed into an austerity bias: executive approval increases when deficits are reduced. These findings contribute to comparative political economy research by assessing how policy regimes and public preferences reinforce each other.
Electroconvulsive therapy (ECT) is one of the most effective treatments for treatment-resistant depression (TRD). However, due to response delay and cognitive impairment, ECT remains an imperfect treatment. Compared to ECT, repetitive transcranial magnetic stimulation (rTMS) is less effective at treating severe depression, but has the advantage of being quick, easy to use, and producing almost no side effects. In this study, our objective was to assess the priming effect of rTMS sessions before ECT on clinical response in patients with TRD.
Methods
In this multicenter, randomized, double-blind, sham-controlled trial, 56 patients with TRD were assigned to active or sham rTMS before ECT treatment. Five sessions of active/sham neuronavigated rTMS were administered over the left dorsolateral prefrontal cortex (20 Hz, 90% resting motor threshold, 20 2 s trains with 60-s intervals, 800 pulses/session) before ECT (which was active for all patients) started. Any relative improvements were then compared between both groups after five ECT sessions, in order to assess the early response to treatment.
Results
After ECT, the active rTMS group exhibited a significantly greater relative improvement than the sham group [43.4% (28.6%) v. 25.4% (17.2%)]. The responder rate in the active group was at least three times higher. Cognitive complaints, which were assessed using the Cognitive Failures Questionnaire, were higher in the sham rTMS group compared to the active rTMS group, but this difference was not corroborated by cognitive tests.
Conclusions
rTMS could be used to enhance the efficacy of ECT in patients with TRD. ClinicalTrials.gov: NCT02830399.
What are the political effects of fiscal consolidations? Theoretical considerations suggest that consolidations should reduce the public’s support for their governments, but empirical studies have found surprisingly small effects on government support. However, most of these studies analyze electoral outcomes, which are separated from the consolidation by a multi-link causal chain. We argue that more direct measures of government support, such as executive approval, show much stronger negative effects of consolidation, since they are less affected by the strategic timing of consolidations or the political alternatives on offer. We analyze a time series cross-sectional dataset of executive approval in 14 Organization for Economic Co-operation and Development (OECD) countries from 1978 to 2014, using the narrative approach to measure fiscal consolidations. We find that spending cuts decrease government approval, especially during economic downturns, but tax increases’ impact on approval remains minimal. Finally, left- and right-wing governments are equally likely to lose approval after implementing austerity.
"Zomia" is a term coined in 2002 to describe the broad swath of mountainous land in Southeast Asia that has always been beyond the reach of lowland governments despite their technical claims to control. This book expands the anthropological reach of that term, applying it to any deterritorialised people, from cast-out migrants to modern resisters-in the process finding new ways to understand the realities of peoples and ethnicities that refuse to become part of the modern state.
This article examines the presence of geographically targeted spending in the allocation of infrastructure projects in Canada. Building on formal models of distributive politics, we expect government districts, core government districts and swing districts to be advantaged in terms of infrastructure projects. We also investigate whether characteristics of Members of Parliament (MPs), such as seniority or holding a cabinet position, influence the distribution of infrastructure projects. Empirically, we analyze the amount of funding allocated by Infrastructure Canada across non-urban federal electoral districts between 2006 and 2018. Our results indicate that non-urban governmental districts receive, on average, more money than opposition districts, and that this is even more the case for core government districts. In contrast, we found little evidence that cabinet ministers or senior MPs are able to attract more funding to their constituencies compared to other representatives.
For many species abundance data from across their entire range are incomplete, and therefore it is difficult to accurately assess their conservation status. Even for species that are large, charismatic and relatively easy to study, conservation assessments are often hampered by lack of data. Here we report a marked, previously undescribed, increase in numbers at a breeding colony of the loggerhead turtle Caretta caretta, a species that is Critically Endangered in several parts of its range, and place this report in the global context for this species. We present a 10-year (2008–2017) dataset of nesting activities for this species on the island of Sal, one of the Cape Verde islands in the Atlantic Ocean. Foot patrols recorded 21,938 nests during the study period. We estimate that the annual number of nests on Sal increased from 506 in 2008 to 7,771 in 2017. Taking into account that there are only two known loggerhead turtle rookeries (on Masirah Island, Oman, and in Florida, USA) with > 50,000 nests reported annually, and few with > 1,000 nests per year, our results suggest that Sal is one of the 10 largest loggerhead turtle rookeries globally. Our work highlights the conservation significance of reporting trends in abundance at breeding sites for marine turtles and other taxa.
A local two-dimensional flow model which accounts for the anisotropic behaviour of polar ice and the evolution of its strain-induced anisotropy is briefly reviewed. Due to its complexity, it is not yet possible to use this model to simulate the flow of a whole ice sheet, and its potential applications are presently restricted to limited spatial domains around existing drilling sites. In order to calculate the local flow of ice, boundary conditions must be applied on the lateral edges of the studied domain. Since these limits correspond to fictitious sections of the ice sheet, the type of boundary condition to adopt is not obvious. In the present paper, different kinds of boundary conditions of the Dirichlet type, applied at the lateral boundary of an idealized ice sheet of simplified geometry, are discussed. This will serve as a first step towards the coupling of the local flow model with a global ice-sheet flow model.
In France, medical devices (MDs) for home-based infusion used to be covered by the health insurance system if included on the list of products and services qualifying for reimbursement under a generic description corresponding to a class of products with the same indications. This coverage modality offered no resistance to unnecessary or wasteful spending. Besides, between 2010 and 2015 the expenditure related to these MDs have increased from EUR192million to EUR289million (+50 percent).
METHODS:
The French National Authority for Health (HAS) has assessed the actual benefit of these MDs which have the same indications as the drugs infused at home. This work led to standardize the infusion types (gravity, elastomeric pump or active system requiring an energy source) and the quantities of MDs needed to carry out the different cares (installation, connection, withdrawal) according to the infusion route. At this step, considering that the priority was to redefine the MDs required at home for each care type, no economical assessment had been conducted.
RESULTS:
Based on this medical assessment, the Ministry of Health has distinguished three types of infusion and three types of services (home installation, monitoring and consumables) since 2016. In total, twenty-four packages have been set up for reimbursement with non-cumulative rules. Doctors are in charge to prescribe the appropriate packages; providers and nurses determine together the optimal devices needed for each patient according to his environment.
CONCLUSIONS:
These HAS recommendations on practice standardization have been the keystone for cost negotiations. The new coverage modalities aim to motivate liberal nurses to choose the best fitted products and providers to deliver the right quantities to patients. The expected benefits are an adjusted evaluation of the necessary equipment and a control of health expenditure due to the fixed costs of each infusion package.
A model for the anisotropic behaviour of polar ice and the evolution of its strain-induced anisotropy is applied to the flowline between GRIP and GISP2. The linear constitutive law for polycrystalline ice is derived from the uniform-stress model under the assumptions of a linear transversely isotropic behaviour of the ice single crystal and of an orthotropic fabric described by a continuous parameterized orientation-distribution function (ODF). The velocities and fabrics obtained for the observed flowline and bedrock geometry assuming stationary flow, are compared to those measured at the ice-sheet surface and down the two boreholes.
Turbulent wakes past bluff bodies commonly present asymmetric flow states reminiscent of bifurcations in the laminar regime. Understanding the sensitivity of these states to flow forcing is crucial to the modelling and control of flow symmetry properties. In this study, the near wake of a rectangular bluff body in proximity to a wall is disturbed by the use of passive devices located between the model and the wall, upstream of the massive flow separation occurring at the blunt trailing edges. Due to the proximity to the boundary, the wake initially presents wall-normal asymmetry and a negative wall-normal pressure gradient along the base. The application of disturbances with variable size, however, sets flow symmetry along the wall-normal plane, leading to the intermittent spanwise wake reversals reported recently in the literature. A further increase in the size of perturbation suppresses wake switching, and wall-normal asymmetry is recovered, but with a positive wall-normal pressure gradient. The dynamical features of this bifurcation scenario can be retrieved using two coupled symmetry-breaking models for spanwise and wall-normal pressure gradients. This confirms the high sensitivity of the separated flow to external perturbations. More importantly, the results unify observations of the bluff-body wake topologies covered in previous investigations.
For accurate ice-sheet flow modelling, the anisotropic behaviour of ice must be taken fully into account. However, physically based micro-macro (μ-M) models for the behaviour of an anisotropic ice polycrystal are too complex to be implemented easily in large-scale ice-sheet flow models. An easy and efficient method to remedy this is presented. Polar ice is assumed to behave as a linearly viscous orthotropic material whose general flow law (GOLF) depends on six parameters, and its orthotropic fabric is described by an ‘orientation distribution function’ (ODF) depending on two parameters. A method to pass from the ODF to a discrete description of the fabric, and vice versa, is presented. Considering any available μ-M model, the parameters of the GOLF that fit the response obtained by running this μ-M model are calculated for any set of ODF parameters. It is thus possible to tabulate the GOLF over a grid in the space of the ODF parameters. This step is performed once and for all. Ice-sheet flow models need the general form of the GOLF to be implemented in the available code (once), then, during each individual run, to retrieve the GOLF parameters from the table by interpolation. As an application example, the GOLF is tabulated using three different μ-M models and used to derive the rheological properties of ice along the Greenland Icecore Project (GRIP) ice core.
A numerical simulation of the flow of the cold glacier of Dôme du Goûter (4304 m, Mont Blanc, France) is presented. Owing to the large thickness of the firn layer, the simulation was done by using a rheological model for porous ice derived from a model for ceramic sintering and adapted to fit available data on in situ measured density profiles and firn mechanical behaviour. The flow calculation was made under the assumptions of axisymmetric geometry and stationary conditions, by solving a coupled problem. For a given density field, the velocities were obtained by the finite-element method. Then the integration of the mass-conservation equation along the streamlines derived from this velocity field gave the corresponding stationary densities. The results of the numerical simulation, besides the velocity and density fields, are the age of the ice along the streamlines. They are compared with observation and field data.