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The Paragaricocrinidae is an enigmatic late Paleozoic family of camerate crinoids that retained a robustly constructed calyx more typical of Devonian to Early Mississippian crinoids. The discovery of the oldest member of this family, Tuscumbiacrinus madisonensis n. gen. n. sp., initiated a phylogenetic investigation of the Paragaricocrinidae and consideration of its diversification and paleobiogeographic distribution. Phylogenetic analyses demonstrate the need to describe Tuscumbiacrinus n. gen and conduct revisions to preexisting taxa, resulting in the description of Palenciacrinus mudaensis n. gen. n. sp.; Pulcheracrinus n. gen.; Nipponicrinus hashimotoi n. gen. n. sp.; and Nipponicrinus akiyoshiensis n. gen. n. sp. Megaliocrinus exotericus Strimple is reassigned to Pulcheracrinus n. gen. In addition to having an anachronistic morphology, relatively few specimens are known through the ca. 76-million-year duration of this family. This pattern is unlikely to have resulted from low fossil sampling alone, and instead likely reflects low abundance and/or taxonomic richness of a long-lived waning clade. From its apparent origination in Laurussia during the Mississippian, the Paragaricocrinidae diversified into a cosmopolitan clade. Following a diversity drop during the Pennsylvanian, the Paragaricocrinidae persisted but exemplified characteristics of a dead clade walking until its eventual extinction during the middle Permian (Wordian).
Unlike conventional meta-analyses, individual patient data (IPD) meta-analysis assesses moderator variables at the level of each participant, which generates more precise and biased estimates. The objective of this study was to investigate whether psychological therapy reduces depression symptoms in people with Bipolar I and II disorders and examine whether baseline depression has a moderating effect on treatment outcomes. Through the use of several electronic databases, a systematic search was conducted. Eligible studies were randomized controlled trials evaluating a psychological intervention for adults diagnosed with Bipolar I or II disorder. Titles and abstracts were screened, followed by full texts. The authors of the included studies were asked to provide IPD from their trials. A multilevel model approach was used to analyze the data. From the 7552 studies found by our searches, six studies with 668 study participants were eligible. Intervention significantly reduced depression scores. There was a significant association between baseline depression and post treatment depression scores. There was no statistically significant interaction between condition allocation and baseline depression score. When IPD from the two most comparable studies were analyzed, CBT had reduced depression scores relative to the comparator condition. The study included patient data from only six studies which were heterogeneous in terms of intervention type, outcome measure, and comparators. Overall, the psychological interventions tested significantly reduced bipolar depression scores. There was no evidence of moderation by baseline depression scores.
Extreme events (e.g. floods and disease outbreaks) can overwhelm healthcare workers (HCWs) and healthcare systems. During the COVID-19 pandemic, high levels of distress and mental ill health were reported by HCWs.
Aims
To examine and synthesise research findings reported in the qualitative literature regarding the stressors, and their psychosocial impacts, faced by HCWs in the UK during the COVID-19 pandemic, and to provide lessons for future support.
Method
Qualitative articles were identified in EMBASE and OVID (preregistered on PROSPERO: CRD42022304235). Studies were required to have been published between January 2021 and January 2022 and to have examined the impact of COVID-19 on UK HCWs. We included 27 articles that represented the experiences of 2640 HCWs, assessed their quality using National Institute for Health and Care Excellence criteria and integrated their findings using thematic synthesis.
Results
Several secondary stressors were identified, including lack of personal protective equipment, ineffective leadership and communication, high workloads and problems stemming from uncertainty and a lack of knowledge. Stressors were related to adverse psychosocial outcomes including worry, fatigue, lack of confidence in oneself and senior managers, impacts on teamwork and feeling unappreciated or that one’s needs are not recognised.
Conclusions
Our thematic synthesis moves beyond simply mapping stressors faced by HCWs by considering their antecedents, origins and psychosocial impacts. Utilising a theoretical framework that points towards systemic deficiencies, we argue that secondary stressors can be modified to remove their negative effects. Consequently, workforce planning should shift from focusing on individual change towards amending psychosocial environments in which HCWs work.
West Papua, Australia's near northern neighbour, has for nearly six decades experienced widespread human rights abuses by the Indonesian state and military. In this article we argue that Australia has the responsibility and the expertise to do more to ensure that West Papuans' human rights are being upheld. First, in a situation as serious as that of West Papua, Australia, as a member of the United Nations, we contend, has a political duty to intervene under the United Nation's ‘responsibility to protect’ doctrine. Second, we put forward that Australia also has a historic and moral obligation to the territory: West Papuans provided vital assistance to Australian troops in 1944 during World War 2. In the 1960s, however, Canberra betrayed its neighbour's preparations for self-determination but we argue Australia now has a chance to right this historical wrong by intervening in West Papua's struggle against Indonesian oppression. Third, we argue that because Australia has set a precedent of intervention when it led the humanitarian intervention in East Timor in 1999-2000, we know that intervention is possible and that the necessary political will can be mustered. Whereas Australia's involvement in the East Timor crisis led to long term diplomatic tension between Australia and Indonesia, however, we propose that in this case, Australia's contribution to addressing human rights in West Papua could ultimately strengthen ties between the two countries.
Cognitive therapy for PTSD (CT-PTSD) is an efficacious treatment for children and adolescents with post-traumatic stress disorder (PTSD) following single incident trauma, but there is a lack of evidence relating to this approach for youth with PTSD following exposure to multiple traumatic experiences.
Aims:
To assess the safety, acceptability and feasibility of CT-PTSD for youth following multiple trauma, and obtain a preliminary estimate of its pre–post effect size.
Method:
Nine children and adolescents (aged 8–17 years) with multiple-trauma PTSD were recruited to a case series of CT-PTSD. Participants completed a structured interview and mental health questionnaires at baseline, post-treatment and 6-month follow-up, and measures of treatment credibility, therapeutic alliance, and mechanisms proposed to underpin treatment response. A developmentally adjusted algorithm for diagnosing PTSD was used.
Results:
No safety concerns or adverse effects were recorded. Suicidal ideation reduced following treatment. No participants withdrew from treatment or from the study. CT-PTSD was rated as highly credible. Participants reported strong working alliances with their therapists. Data completion was good at post-treatment (n=8), but modest at 6-month follow-up (n=6). Only two participants met criteria for PTSD (developmentally adjusted algorithm) at post-treatment. A large within-subjects treatment effect was observed post-treatment and at follow up for PTSD severity (using self-report questionnaire measures; ds>1.65) and general functioning (CGAS; ds<1.23). Participants showed reduced anxiety and depression symptoms at post-treatment and follow-up (RCADS-C; ds>.57).
Conclusions:
These findings suggest that CT-PTSD is a safe, acceptable and feasible treatment for children with multiple-trauma PTSD, which warrants further evaluation.
Law and society scholars have long studied rights mobilization and gender inequality from the vantage point of complainants in private workplaces. This article pursues a new direction in this line of inquiry to explore, for the first time, mobilization from the vantage points of complainants and those accused of violating the rights of others in public-school workplaces in the United States. We conceptualize rights mobilization as legal, quasilegal, and/or extralegal processes. Based on a national random survey of teachers and administrators, and in-depth interviews with educators in California, New York, and North Carolina, we find an integral relationship between gender inequality and experiencing rights violations, choices about rights mobilization, and obstacles to formal mobilization. Compared to complainants, those accused of rights violations – especially male administrators – are more likely to use quasilegal and legal mobilization to defend themselves or to engage in anticipatory mobilization. Actors in less powerful status positions (teachers) most often pursue extralegal mobilization to complain about rights violations during which they engage in rights muting as a means of self-protection; when in more powerful status positions, actors use rights muting as a means of self-protection and to suppress the rights claims of others. This paper concludes with implications for future research on rights mobilization in school workplaces amidst changing political and demographic conditions.
Mental health problems are elevated in autistic individuals but there is limited evidence on the developmental course of problems across childhood. We compare the level and growth of anxious-depressed, behavioral and attention problems in an autistic and typically developing (TD) cohort.
Methods
Latent growth curve models were applied to repeated parent-report Child Behavior Checklist data from age 2–10 years in an inception cohort of autistic children (Pathways, N = 397; 84% boys) and a general population TD cohort (Wirral Child Health and Development Study; WCHADS; N = 884, 49% boys). Percentile plots were generated to quantify the differences between autistic and TD children.
Results
Autistic children showed elevated levels of mental health problems, but this was substantially reduced by accounting for IQ and sex differences between the autistic and TD samples. There was small differences in growth patterns; anxious-depressed problems were particularly elevated at preschool and attention problems at late childhood. Higher family income predicted lower base-level on all three dimensions, but steeper increase of anxious-depressed problems. Higher IQ predicted lower level of attention problems and faster decline over childhood. Female sex predicted higher level of anxious-depressed and faster decline in behavioral problems. Social-affect autism symptom severity predicted elevated level of attention problems. Autistic girls' problems were particularly elevated relative to their same-sex non-autistic peers.
Conclusions
Autistic children, and especially girls, show elevated mental health problems compared to TD children and there are some differences in predictors. Assessment of mental health should be integrated into clinical practice for autistic children.
The coronavirus disease 2019 (COVID-19) pandemic highlighted the lack of agreement regarding the definition of aerosol-generating procedures and potential risk to healthcare personnel. We convened a group of Massachusetts healthcare epidemiologists to develop consensus through expert opinion in an area where broader guidance was lacking at the time.
In the general population, irritability is associated with later depression. Despite irritability being more prevalent in autistic children, the long-term sequelae are not well explored. We tested whether irritability in early childhood predicted depression symptoms in autistic adolescents, and whether associations could be explained by difficulties in peer relationships and lower educational engagement. Analyses tested the longitudinal associations between early childhood irritability (ages 3–5) and adolescent depression symptoms (age 14) in a prospective inception cohort of autistic children (N = 390), followed from early in development shortly after they received a clinical diagnosis. Mediators were measured in mid-childhood (age 10) by a combination of measures, from which latent factors for peer relationships and educational engagement were estimated. Results showed early childhood irritability was positively associated with adolescent depression symptoms, and this association remained when adjusting for baseline depression. A significant indirect pathway through peer relationships was found, which accounted for around 13% of the association between early childhood irritability and adolescent depression, suggesting peer problems may partially mediate the association between irritability and later depression. No mediation effects were found for education engagement. Results highlight the importance of early screening and intervention for co-occurring irritability and peer problems in young autistic children.
Hospitals are increasingly consolidating into health systems. Some systems have appointed healthcare epidemiologists to lead system-level infection prevention programs. Ideal program infrastructure and support resources have not been described. We informally surveyed 7 healthcare epidemiologists with recent experience building and leading system-level infection prevention programs. Key facilitators and barriers for program structure and implementation are described.
The Intergovernmental Panel on Climate Change has documented wide-ranging changes to the world's coasts and oceans, with significant further change predicted. Impacts on coastal and underwater heritage sites, however, remain relatively poorly understood. The authors draw on 30 years of research into coastal and underwater archaeological sites to highlight some of the interrelated processes of deterioration and damage. Emphasising the need for closer collaboration between, on one hand, archaeologists and cultural resource managers and, on the other, climate and marine scientists, this article also discusses research from other disciplines that informs understanding of the complexity of the interaction of natural and anthropogenic processes and their impacts on cultural heritage.
Many male prisoners have significant mental health problems, including anxiety and depression. High proportions struggle with homelessness and substance misuse.
Aims
This study aims to evaluate whether the Engager intervention improves mental health outcomes following release.
Method
The design is a parallel randomised superiority trial that was conducted in the North West and South West of England (ISRCTN11707331). Men serving a prison sentence of 2 years or less were individually allocated 1:1 to either the intervention (Engager plus usual care) or usual care alone. Engager included psychological and practical support in prison, on release and for 3–5 months in the community. The primary outcome was the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM), 6 months after release. Primary analysis compared groups based on intention-to-treat (ITT).
Results
In total, 280 men were randomised out of the 396 who were potentially eligible and agreed to participate; 105 did not meet the mental health inclusion criteria. There was no mean difference in the ITT complete case analysis between groups (92 in each arm) for change in the CORE-OM score (1.1, 95% CI –1.1 to 3.2, P = 0.325) or secondary analyses. There were no consistent clinically significant between-group differences for secondary outcomes. Full delivery was not achieved, with 77% (108/140) receiving community-based contact.
Conclusions
Engager is the first trial of a collaborative care intervention adapted for prison leavers. The intervention was not shown to be effective using standard outcome measures. Further testing of different support strategies for prison with mental health problems is needed.
Training plays a central role in the pursuit of conservation goals, and it is vital to know if it is having the desired effect. However, evaluating the difference it makes is notoriously challenging. Here, we present a practitioner's perspective on overcoming these challenges and developing a framework for ongoing evaluation of a conservation training programme. To do this, we first created a theory of change, describing the pathway of change we expect from training delivery to conservation impact. This provided the clarity and structure needed to identify indicators of change in the short, medium and long term. For data collection, we utilized both quantitative and qualitative methods to provide a more complete understanding of the change expected and capture any that might be unexpected. However, the more time that passes since a training event, the more difficult it becomes to attribute results; in response, we shifted predominantly to the use of qualitative methods to understand the long-term results achieved. After 3 years of implementation, this framework has enabled us to measure the difference our training makes to individuals and their work, and to provide evidence for the contribution it makes to achieving conservation impact. We believe that the lessons learnt can be used to improve the evaluation of training activities across the conservation sector and maximize the impact they achieve.
The state of California, in the United States of America, has a population of nearly 40 million people and is the 5th largest economy in the world. During the coronavirus disease 2019 (COVID-19) pandemic in 2020-2021, the state experienced a medical surge that stressed its sophisticated health-care and public health system. During this period, ventilators, oxygen, and other equipment necessary for providing ventilatory support became a scarce resource in many health-care settings. When demand overwhelms supply, creative solutions are required at all levels of disaster management and health care. This study describes the disaster response by the state of California to mitigate the emergency demands for oxygen delivery resources.
Ethnohistoric accounts indicate that the people of Australia's Channel Country engaged in activities rarely recorded elsewhere on the continent, including food storage, aquaculture and possible cultivation, yet there has been little archaeological fieldwork to verify these accounts. Here, the authors report on a collaborative research project initiated by the Mithaka people addressing this lack of archaeological investigation. The results show that Mithaka Country has a substantial and diverse archaeological record, including numerous large stone quarries, multiple ritual structures and substantial dwellings. Our archaeological research revealed unknown aspects, such as the scale of Mithaka quarrying, which could stimulate re-evaluation of Aboriginal socio-economic systems in parts of ancient Australia.
HIV-associated neurocognitive disorders (HANDs) are prevalent in older people living with HIV (PLWH) worldwide. HAND prevalence and incidence studies of the newly emergent population of combination antiretroviral therapy (cART)-treated older PLWH in sub-Saharan Africa are currently lacking. We aimed to estimate HAND prevalence and incidence using robust measures in stable, cART-treated older adults under long-term follow-up in Tanzania and report cognitive comorbidities.
Design:
Longitudinal study
Participants:
A systematic sample of consenting HIV-positive adults aged ≥50 years attending routine clinical care at an HIV Care and Treatment Centre during March–May 2016 and followed up March–May 2017.
Measurements:
HAND by consensus panel Frascati criteria based on detailed locally normed low-literacy neuropsychological battery, structured neuropsychiatric clinical assessment, and collateral history. Demographic and etiological factors by self-report and clinical records.
Results:
In this cohort (n = 253, 72.3% female, median age 57), HAND prevalence was 47.0% (95% CI 40.9–53.2, n = 119) despite well-managed HIV disease (Mn CD4 516 (98-1719), 95.5% on cART). Of these, 64 (25.3%) were asymptomatic neurocognitive impairment, 46 (18.2%) mild neurocognitive disorder, and 9 (3.6%) HIV-associated dementia. One-year incidence was high (37.2%, 95% CI 25.9 to 51.8), but some reversibility (17.6%, 95% CI 10.0–28.6 n = 16) was observed.
Conclusions:
HAND appear highly prevalent in older PLWH in this setting, where demographic profile differs markedly to high-income cohorts, and comorbidities are frequent. Incidence and reversibility also appear high. Future studies should focus on etiologies and potentially reversible factors in this setting.
In this study, segmental and prosodic properties of word-length stimuli were assessed together. Six talkers from 5 L1 backgrounds (American English, Hindi, Korean, Mandarin, and Spanish) were recorded reading English stop-initial trochaic words. The productions were played for 20 monolingual American English-speaking listeners rated the accentedness of each talker. For each token, the deviation from native English productions was determined for segmental (VOT, vowel quality) and three prosodic properties (ratios of duration, intensity, f0 across the two syllables). For each non-native language background, a linear mixed-effects regression model was created to predict accentedness ratings from the phonetic deviations, and the significance of each fixed effect was examined. In each model, the significant predictors included both segmental and prosodic properties. For Hindi and Spanish talkers, the single best predictor was segmental; however, for Korean and Mandarin talkers, the single best predictor was prosodic. Thus, even for short stimuli, both segmental and prosodic information must be considered in accounting for accentedness judgments. We conclude that listeners are sensitive to the different ways that foreign accent may be manifested across different non-native backgrounds.
Lacustrine sedimentary records and the proxies contained within them are valuable archives of past climate. However, the resolution of these records is frequently coarse or contains a high degree of uncertainty, making it difficult to resolve how climatic variability impacts the ecosystems on which humans depend. The goal of this study is to couple recent sediment cores sampled at centimeter-scale resolution with paleo- and historical information about lake levels to document how changes in the paleoenvironment impact the paleoecology of a rift basin lake. We present multiproxy data from three short cores collected from Ferguson's Gulf (FG), a shallow embayment connected to the western shore of Lake Turkana, Kenya. Five distinct biozones were interpreted on the basis of ostracods and geochemistry (δ18O, δ13C, and major elements), spanning the Little Ice Age (LIA) to the modern. Overall, ostracod total abundance and assemblage diversity decreased up-core, with the largest total abundance and genera diversity occurring during the LIA. This fits with regional datasets that indicate the Eastern Branch of the East African Rift System was wetter during the LIA than it is today. This also suggests that human impact in and around Lake Turkana has weakened the resiliency of the ecosystems in FG.