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It remains unclear which individuals with subthreshold depression benefit most from psychological intervention, and what long-term effects this has on symptom deterioration, response and remission.
Aims
To synthesise psychological intervention benefits in adults with subthreshold depression up to 2 years, and explore participant-level effect-modifiers.
Method
Randomised trials comparing psychological intervention with inactive control were identified via systematic search. Authors were contacted to obtain individual participant data (IPD), analysed using Bayesian one-stage meta-analysis. Treatment–covariate interactions were added to examine moderators. Hierarchical-additive models were used to explore treatment benefits conditional on baseline Patient Health Questionnaire 9 (PHQ-9) values.
Results
IPD of 10 671 individuals (50 studies) could be included. We found significant effects on depressive symptom severity up to 12 months (standardised mean-difference [s.m.d.] = −0.48 to −0.27). Effects could not be ascertained up to 24 months (s.m.d. = −0.18). Similar findings emerged for 50% symptom reduction (relative risk = 1.27–2.79), reliable improvement (relative risk = 1.38–3.17), deterioration (relative risk = 0.67–0.54) and close-to-symptom-free status (relative risk = 1.41–2.80). Among participant-level moderators, only initial depression and anxiety severity were highly credible (P > 0.99). Predicted treatment benefits decreased with lower symptom severity but remained minimally important even for very mild symptoms (s.m.d. = −0.33 for PHQ-9 = 5).
Conclusions
Psychological intervention reduces the symptom burden in individuals with subthreshold depression up to 1 year, and protects against symptom deterioration. Benefits up to 2 years are less certain. We find strong support for intervention in subthreshold depression, particularly with PHQ-9 scores ≥ 10. For very mild symptoms, scalable treatments could be an attractive option.
The stellar age and mass of galaxies have been suggested as the primary determinants for the dynamical state of galaxies, with environment seemingly playing no or only a very minor role. We use a sample of 77 galaxies at intermediate redshift ($z\sim0.3$) in the Middle-Ages Galaxies Properties with Integral field spectroscopy (MAGPI) Survey to study the subtle impact of environment on galaxy dynamics. We use a combination of statistical techniques (simple and partial correlations and principal component analysis) to isolate the contribution of environment on galaxy dynamics, while explicitly accounting for known factors such as stellar age, star formation histories, and stellar masses. We consider these dynamical parameters: high-order kinematics of the line-of-sight velocity distribution (parametrised by the Gauss-Hermite coefficients $h_3$ and $h_4$), kinematic asymmetries $V_{\textrm{asym}}$ derived using kinemetry, and the observational spin parameter proxy $\lambda_{R_e}$. Of these, the mean $h_4$ is the only parameter found to have a significant correlation with environment as parametrised by group dynamical mass. This correlation exists even after accounting for age and stellar mass trends. We also find that satellite and central galaxies exhibit distinct dynamical behaviours, suggesting they are dynamically distinct classes. Finally, we confirm that variations in the spin parameter $\lambda_{R_e}$ are most strongly (anti-)correlated with age as seen in local studies, and show that this dependence is well-established by $z\sim0.3$.
This work presents visual morphological and dynamical classifications for 637 spatially resolved galaxies, most of which are at intermediate redshift (z ∼ 0.3), in the Middle-Ages Galaxy Properties with Integral field spectroscopy (MAGPI) Survey. For each galaxy, we obtain a minimum of 11 independent visual classifications by knowledgeable classifiers. We use an extension of the standard Dawid-Skene Bayesian model introducing classifier-specific confidence parameters and galaxy-specific difficulty parameters to quantify classifier confidence and infer reliable statistical confidence estimates. Selecting sub-samples of 86 bright (r < 20 mag) high-confidence (> 0.98) morphological classifications at redshifts (0.2 ≤ z ≤ 0.4), we confirm the full range of morphological types is represented in MAGPI as intended in the survey design. Similarly, with a sub-sample of 82 bright high-confidence stellar kinematic classifications, we find that the rotating and non-rotating galaxies seen at low redshift are already in place at intermediate redshifts. We do not find evidence that the kinematic morphology-density relation seen at z ∼ 0 is established at z ∼ 0.3. We suggest that galaxies without obvious stellar rotation are dynamically pre-processed sometime before z ∼ 0.3 within lower mass groups before joining denser environments.
Psychiatry and clinical psychology are closely related disciplines, and both overlap and affect each other. However, psychiatry is also substantially influenced by more basic psychological theories. Learning theories starting with behavioral concepts have been used for understanding and treating anxiety and addiction, for example. Cognitive theory has had a major impact on treatments for depression and psychosis. Therefore, in this chapter, we will present five psychological theories (psychoanalysis, behaviorism, cognitive theory, social learning, and mindfulness-based concepts) that we regard as historically most influential and useful for psychiatry. In addition, the stress-vulnerability model and the humanistic psychology approach will be outlined. The former provides a general etiological model of almost all psychiatric disorders, whereas the humanistic ideas help conceptualize and establish therapeutic stance and a good client–provider relationship.
Manipulating matter by strong coupling to the vacuum field has attracted intensive interests over the last decade. In particular, vibrational strong coupling (VSC) has shown great potential for modifying ground state properties in solution chemistry and biochemical processes. In this work, the effect of VSC of water on the melting behaviour of ds-DNA, an important biophysical process, is explored. Several experimental conditions, including the concentration of ds-DNA, cavity profile, solution environment, as well as thermal annealing treatment, were tested. No significant effect of VSC was observed for the melting behaviour of the ds-DNA sequence used. This demonstrates yet again the robustness of ds-DNA to outside perturbations. Our work also provides a general protocol to probe the effects of VSC on biological systems inside microfluid Fabry–Perot cavities and should be beneficial to better understand and harness this phenomenon.
In this article, we focus on the development of Rome: The Game – a large, lower-division online course crossed-listed in the History of Art and Architecture Department and Writing Program at the University of California, Santa Barbara – that features a choose-your-own-adventure-style interactive narrative. We explore the design principles underpinning the development of this type of gamified course, the mechanics of the course itself, student experiences, and learning outcomes. Citing relevant research in several fields – such as game studies, educational psychology, and communication studies – we argue that creating an online course in the style of an interactive, narrative-driven digital game presents a model for engaging and effective active learning in an online environment – one that goes beyond conventional virtual learning to offer an innovative, active, and deeply immersive model for online teaching.
Edited by
Allan Young, Institute of Psychiatry, King's College London,Marsal Sanches, Baylor College of Medicine, Texas,Jair C. Soares, McGovern Medical School, The University of Texas,Mario Juruena, King's College London
Accurate diagnoses are crucial in choosing the most appropriate evidence-based treatment for mood disorders. Structured clinical interviews are the gold standard to assess unipolar (UD) and bipolar disorders (BD); however, they require time, financial, and training resources that are often unavailable. As this is especially true outside of specialty clinics or tertiary care settings, self-ratings can be used for screening to facilitate the diagnostic process. Such tools have both strengths and weaknesses, but it is essential that a detailed clinical assessment still follows before providing a valid diagnosis for mood disorders. In this chapter, we review several screening tools for UD and BD that have substantial empirical support and/or are widely used. We list measures that have been used for other types of screening, for example, to assess severity of symptoms or focus on specific populations. Gaps, recent developments, such as digital approaches, and final conclusions for clinical practice are also discussed.
n-3 fatty acid consumption during pregnancy is recommended for optimal pregnancy outcomes and offspring health. We examined characteristics associated with self-reported fish or n-3 supplement intake.
Design:
Pooled pregnancy cohort studies.
Setting:
Cohorts participating in the Environmental influences on Child Health Outcomes (ECHO) consortium with births from 1999 to 2020.
Participants:
A total of 10 800 pregnant women in twenty-three cohorts with food frequency data on fish consumption; 12 646 from thirty-five cohorts with information on supplement use.
Results:
Overall, 24·6 % reported consuming fish never or less than once per month, 40·1 % less than once a week, 22·1 % 1–2 times per week and 13·2 % more than twice per week. The relative risk (RR) of ever (v. never) consuming fish was higher in participants who were older (1·14, 95 % CI 1·10, 1·18 for 35–40 v. <29 years), were other than non-Hispanic White (1·13, 95 % CI 1·08, 1·18 for non-Hispanic Black; 1·05, 95 % CI 1·01, 1·10 for non-Hispanic Asian; 1·06, 95 % CI 1·02, 1·10 for Hispanic) or used tobacco (1·04, 95 % CI 1·01, 1·08). The RR was lower in those with overweight v. healthy weight (0·97, 95 % CI 0·95, 1·0). Only 16·2 % reported n-3 supplement use, which was more common among individuals with a higher age and education, a lower BMI, and fish consumption (RR 1·5, 95 % CI 1·23, 1·82 for twice-weekly v. never).
Conclusions:
One-quarter of participants in this large nationwide dataset rarely or never consumed fish during pregnancy, and n-3 supplement use was uncommon, even among those who did not consume fish.
The European Congenital Heart Surgeons Association (ECHSA) Congenital Database (CD) is the second largest clinical pediatric and congenital cardiac surgical database in the world and the largest in Europe, where various smaller national or regional databases exist. Despite the dramatic increase in interventional cardiology procedures over recent years, only scattered national or regional databases of such procedures exist in Europe. Most importantly, no congenital cardiac database exists in the world that seamlessly combines both surgical and interventional cardiology data on an international level; therefore, the outcomes of surgical and interventional procedures performed on the same or similar patients cannot easily be tracked, assessed, and analyzed. In order to fill this important gap in our capability to gather and analyze information on our common patients, ECHSA and The Association for European Paediatric and Congenital Cardiology (AEPC) have embarked on a collaborative effort to expand the ECHSA-CD with a new module designed to capture data about interventional cardiology procedures. The purpose of this manuscript is to describe the concept, the structure, and the function of the new AEPC Interventional Cardiology Part of the ECHSA-CD, as well as the potentially valuable synergies provided by the shared interventional and surgical analyses of outcomes of patients. The new AEPC Interventional Cardiology Part of the ECHSA-CD will allow centers to have access to robust surgical and transcatheter outcome data from their own center, as well as robust national and international aggregate outcome data for benchmarking. Each contributing center or department will have access to their own data, as well as aggregate data from the AEPC Interventional Cardiology Part of the ECHSA-CD. The new AEPC Interventional Cardiology Part of the ECHSA-CD will allow cardiology centers to have access to aggregate cardiology data, just as surgical centers already have access to aggregate surgical data. Comparison of surgical and catheter interventional outcomes could potentially strengthen decision processes. A study of the wealth of information collected in the database could potentially also contribute toward improved early and late survival, as well as enhanced quality of life of patients with pediatric and/or congenital heart disease treated with surgery and interventional cardiac catheterization across Europe and the world.
Edited by
Claudia Landwehr, Johannes Gutenberg Universität Mainz, Germany,Thomas Saalfeld, Otto-Friedrich-Universität Bamberg, Germany,Armin Schäfer, Johannes Gutenberg Universität Mainz, Germany
Edited by
Claudia Landwehr, Johannes Gutenberg Universität Mainz, Germany,Thomas Saalfeld, Otto-Friedrich-Universität Bamberg, Germany,Armin Schäfer, Johannes Gutenberg Universität Mainz, Germany
Edited by
Claudia Landwehr, Johannes Gutenberg Universität Mainz, Germany,Thomas Saalfeld, Otto-Friedrich-Universität Bamberg, Germany,Armin Schäfer, Johannes Gutenberg Universität Mainz, Germany
Edited by
Claudia Landwehr, Johannes Gutenberg Universität Mainz, Germany,Thomas Saalfeld, Otto-Friedrich-Universität Bamberg, Germany,Armin Schäfer, Johannes Gutenberg Universität Mainz, Germany
Edited by
Claudia Landwehr, Johannes Gutenberg Universität Mainz, Germany,Thomas Saalfeld, Otto-Friedrich-Universität Bamberg, Germany,Armin Schäfer, Johannes Gutenberg Universität Mainz, Germany
Edited by
Claudia Landwehr, Johannes Gutenberg Universität Mainz, Germany,Thomas Saalfeld, Otto-Friedrich-Universität Bamberg, Germany,Armin Schäfer, Johannes Gutenberg Universität Mainz, Germany
On January 6, 2021, angry supporters of the outgoing president, Donald Trump, stormed the US Capitol building, harassed members of Congress and staff, and mocked democratic symbols. The protestors violently expressed a widespread sentiment among Republican voters that the election was rigged, and that Joe Biden should not be sworn in as the new president of the United States. If democracy depends on the support of those who voted for the losing party to accept the result of the election as legitimate, the events on Capitol Hill showed that this “losers’ consent” (Anderson et al., 2005) is crumbling. Although the degree of polarization in the United States is severe, other advanced democracies face similar challenges. A substantial number of citizens feel that the political system has deep flaws, that politicians have lost touch, and that political decisions do not reflect the preferences of the majority anymore. The chapters in this book highlight the pervasiveness of these problems across a variety of institutional and political settings well beyond the United States.
Edited by
Claudia Landwehr, Johannes Gutenberg Universität Mainz, Germany,Thomas Saalfeld, Otto-Friedrich-Universität Bamberg, Germany,Armin Schäfer, Johannes Gutenberg Universität Mainz, Germany
Edited by
Claudia Landwehr, Johannes Gutenberg Universität Mainz, Germany,Thomas Saalfeld, Otto-Friedrich-Universität Bamberg, Germany,Armin Schäfer, Johannes Gutenberg Universität Mainz, Germany
Edited by
Claudia Landwehr, Johannes Gutenberg Universität Mainz, Germany,Thomas Saalfeld, Otto-Friedrich-Universität Bamberg, Germany,Armin Schäfer, Johannes Gutenberg Universität Mainz, Germany
Edited by
Claudia Landwehr, Johannes Gutenberg Universität Mainz, Germany,Thomas Saalfeld, Otto-Friedrich-Universität Bamberg, Germany,Armin Schäfer, Johannes Gutenberg Universität Mainz, Germany
Edited by
Claudia Landwehr, Johannes Gutenberg Universität Mainz, Germany,Thomas Saalfeld, Otto-Friedrich-Universität Bamberg, Germany,Armin Schäfer, Johannes Gutenberg Universität Mainz, Germany