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Associations of negative affective biases and depressive symptoms in a community-based sample
- Laura de Nooij, Mark J. Adams, Emma L. Hawkins, Liana Romaniuk, Marcus R. Munafò, Ian S. Penton-Voak, Rebecca Elliott, Amy R. Bland, Gordon D. Waiter, Anca-Larisa Sandu, Tina Habota, J. Douglas Steele, Alison D. Murray, Archie Campbell, David J. Porteous, Generation Scotland, Andrew M. McIntosh, Heather C. Whalley
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- Journal:
- Psychological Medicine / Volume 53 / Issue 12 / September 2023
- Published online by Cambridge University Press:
- 21 September 2022, pp. 5518-5527
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- Article
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Background
Major depressive disorder (MDD) was previously associated with negative affective biases. Evidence from larger population-based studies, however, is lacking, including whether biases normalise with remission. We investigated associations between affective bias measures and depressive symptom severity across a large community-based sample, followed by examining differences between remitted individuals and controls.
MethodsParticipants from Generation Scotland (N = 1109) completed the: (i) Bristol Emotion Recognition Task (BERT), (ii) Face Affective Go/No-go (FAGN), and (iii) Cambridge Gambling Task (CGT). Individuals were classified as MDD-current (n = 43), MDD-remitted (n = 282), or controls (n = 784). Analyses included using affective bias summary measures (primary analyses), followed by detailed emotion/condition analyses of BERT and FAGN (secondary analyses).
ResultsFor summary measures, the only significant finding was an association between greater symptoms and lower risk adjustment for CGT across the sample (individuals with greater symptoms were less likely to bet more, despite increasingly favourable conditions). This was no longer significant when controlling for non-affective cognition. No differences were found for remitted-MDD v. controls. Detailed analysis of BERT and FAGN indicated subtle negative biases across multiple measures of affective cognition with increasing symptom severity, that were independent of non-effective cognition [e.g. greater tendency to rate faces as angry (BERT), and lower accuracy for happy/neutral conditions (FAGN)]. Results for remitted-MDD were inconsistent.
ConclusionsThis suggests the presence of subtle negative affective biases at the level of emotion/condition in association with depressive symptoms across the sample, over and above those accounted for by non-affective cognition, with no evidence for affective biases in remitted individuals.
Diagonal Interventions in Infection Prevention: Successful Collaboratives to Decrease CLABSI at a VA Health Care System
- Amy S. Steele, Abigail Carlson, Shay L. Drummond
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 41 / Issue S1 / October 2020
- Published online by Cambridge University Press:
- 02 November 2020, pp. s191-s192
- Print publication:
- October 2020
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Background: Vertical interventions in public health are disease focused, whereas horizontal interventions are systems based. The new concept of “diagonal interventions” merging these 2 approaches is also applicable to infection prevention (IP). During fiscal year (FY) 2016, our facility identified 14 central-line–associated blood stream infections (CLABSIs), resulting in a rate of 1.44 cases per 1,000 catheter days, twice that of FY2015 (0.75 cases per 1,000 catheter days). Methods: Focusing on a horizontal “systems building” approach, the IP team used previously developed informal relationships to mobilize a formal multidisciplinary team comprised of IP, nursing educators, the intravenous therapy team, and frontline staff. Initially charged with implementation of disinfecting caps for needleless connectors, the IP team capitalized on this multidisciplinary resource to launch a multifaceted communication and education campaign supporting CLABSI-specific interventions. For vertical interventions, an IP risk assessment revealed variations in care and maintenance of central lines and the need for staff education. A literature search was conducted to identify evidence-based strategies for reducing CLABSIs, leading to the development of a nursing-led bundle of the following elements: (1) education on CDC hand hygiene guidelines, (2) central-line competency validation and assessment for nurses on hire and annually, (3) standardized processes across all wards for central-line dressing changes (“timed on Tuesdays”), and (4) a pilot program for disinfecting caps on 3 inpatient wards. The IP team identified CLABSIs using standard NHSN definitions. Catheter days were obtained on each inpatient ward. Unit-specific rates were calculated per 1,000 catheter days. Mann-Kendall Test was used to assess rate trends over time, whereas the Fisher exact test was used for rate comparisons. A P < .05 was considered significant. Results: CLABSI rates decreased from 1.44 in FY2016 to 0.12 in FY2019 (Kendall τ = −0.5; P < .001) (Fig. 1). During the 3-month pilot phase of disinfecting caps, no CLABSIs were identified on 3 intervention wards versus 3 CLABSIs on control wards (rate, 0 vs 2.57; P = .27) and 1 CLABSI in the 3-month baseline period prior to the intervention (0 vs 0.40; P > .99). Disinfecting caps were expanded house-wide beginning in FY2018. The multidisciplinary team evolved into a sustained collaborative (“Scrub Club”) meeting biweekly. They have now broadened their focus to quality improvement initiatives for multiple healthcare-associated infections (HAIs). Conclusions: The IP team has traditionally utilized vertical models of intervention. The use of “diagonal” models that incorporate horizontal health systems strengthening can transform multidisciplinary partnerships into long-term collaboratives essential for sustained reduction of HAIs.
Funding: None
Disclosures: None