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The relative burden and risk of readmission for people with personality disorders in hospital settings is unknown.
To compare hospital use of people with personality disorder with that of people with other mental health diagnoses, such as psychoses and affective disorders.
Naturalistic study of hospital presentations for mental health in a large community catchment. Mixed-effects Cox regression and survival curves were generated to examine risk of readmission for each group.
Of 2894 people presenting to hospital, patients with personality disorder represented 20.5% of emergency and 26.6% of in-patients. Patients with personality disorder or psychoses were 2.3 times (95% CI 1.79–2.99) more likely than others to re-present within 28 days. Personality disorder diagnosis increases rate of readmission by a factor of 8.7 (s.e. = 0.31), marginally lower than psychotic disorders (10.02, s.e. = 0.31).
Personality disorders place significant demands on in-patient and emergency departments, similar to that of psychoses in terms of presentation and risk of readmission.
The study objective was to determine the prevalence of Staphylococcus aureus colonisation in the nares and oropharynx of healthy persons and identify any risk factors associated with such S. aureus colonisation. In total 263 participants (177 adults and 86 minors) comprising 95 families were enrolled in a year-long prospective cohort study from one urban and one rural county in eastern Iowa, USA, through local newspaper advertisements and email lists and through the Keokuk Rural Health Study. Potential risk factors including demographic factors, medical history, farming and healthcare exposure were assessed. Among the participants, 25.4% of adults and 36.1% minors carried S. aureus in their nares and 37.9% of adults carried it in their oropharynx. The overall prevalence was 44.1% among adults and 36.1% for minors. Having at least one positive environmental site for S. aureus in the family home was associated with colonisation (prevalence ratio: 1.34, 95% CI: 1.07–1.66). The sensitivity of the oropharyngeal cultures was greater than that of the nares cultures (86.1% compared with 58.2%, respectively). In conclusion, the nares and oropharynx are both important colonisation sites for healthy community members and the presence of S. aureus in the home environment is associated with an increased probability of colonisation.
There are limited data on detection disparities of common mental
disorders in minority ethnic women.
Describe the natural history of common mental disorders in primary care
in the maternal period, characterise women with, and explore ethnic
disparities in, detected and potentially missed common mental
Secondary analyses of linked birth cohort and primary care data involving
8991 (39.4% White British) women in Bradford. Common mental disorders
were characterised through indications in the electronic medical record.
Potentially missed common mental disorders were defined as an elevated
General Health Questionnaire (GHQ-28) score during pregnancy with no
corresponding common mental disorder markers in the medical record.
Estimated prevalence of pre-birth common mental disorders was 9.5%,
rising to 14.0% 3 years postnatally. Up to half of cases were potentially
missed. Compared with White British women, minority ethnic women were
twice as likely to have potentially missed common mental disorders and
half as likely to have a marker of screening for common mental
Common mental disorder detection disparities exist for minority ethnic
women in the maternal period.
In an attempt to distill what we know about the effects of workplace mindfulness-based training, Hyland, Lee, and Mills (2015) cast a wide net with regard to the array of studies included in their review. For example, they include studies that investigate the benefits associated with workplace mindfulness training (e.g., Wolever et al., 2012) as well as training conducted for patients within primary care settings (e.g., Allen, Bromley, Kuyken, & Sonnenberg, 2009). In addition, their review includes studies based on self-reports of individual differences in mindfulness traits/skills (e.g., Hafenbrack, Kinias, & Barsade, 2014). Reviewing a broad cross-section of research is helpful to illustrate the wide-ranging nature of mindfulness research but also has the potential to obfuscate what we know about mindfulness as it pertains to workers and workplaces.
The Income Deprivation Affecting Children Index (IDACI) uses administrative data to count children living in households in receipt of both in-work and out-of-work means-tested benefits and provides small area ranking as an indicator of child poverty in neighbourhoods. Benefit take-up rates within an area will affect its reliability. We aimed to examine benefit take-up rates and compare area ranking by the IDACI with ranking using individually reported data across areas of varying ethnic composition. Mothers living in areas with high minority ethnic density were less likely to report claiming a benefit than those in majority White or mixed areas, despite reporting lower incomes. The correlation between self-reported material difficulties and worsening IDACI rank was much lower in areas characterised by minority ethnic populations. Further investigation into the performance of area-based deprivation measures in areas with high minority ethnic density is needed.
Understanding the fundamental properties of macromolecules has enhanced the development of emerging technologies used to improve biomedical research. Currently, there is a critical need for innovative platforms that can illuminate the function of biomedical reagents in a native environment. To address this need, we have developed an in situ approach to visualize the dynamic behavior of biomedically relevant macromolecules at the nanoscale. Newly designed silicon nitride devices containing integrated “microwells” were used to enclose active macromolecular specimens in liquid for transmission electron microscopy imaging purposes.We were able to successfully examine novel magnetic resonance imaging contrast reagents, micelle suspensions, liposome carrier vehicles, and transcribing viral assemblies. With each specimen tested, the integrated microwells adequately maintained macromolecules in discrete local environments while enabling thin liquid layers to be produced.
Objective: To assess the association of mode of conception and sex concordance with neonatal outcomes in very preterm twins. Study design: Twin pairs born at gestational age ≤32 weeks and admitted to a Level 3 neonatal intensive care unit (NICU) in 2010–2011 were retrospectively identified from the Canadian Neonatal Network™ database. A composite outcome representing neonatal mortality or any severe morbidity (intraventricular hemorrhage grades ≥3 or periventricular leukomalacia, retinopathy of prematurity stages ≥3, bronchopulmonary dysplasia, or necrotizing enterocolitis stages ≥2) was compared between twins conceived using assisted reproduction technologies (ARTs) or spontaneously (SP), and tested for association with sex concordance in individual-level and pair-wise multivariable logistic regression analyses. Results: Study subjects included 1,508 twins from 216 ART (53 [25%] male–male, 104 [48%] male–female, and 59 [27%] female–female) and 538 SP (192 [36%] male–male, 123 [23%] male–female, and 223 [41%] female–female) pairs. No statistically significant association was detected between mode of conception and the composite outcome of mortality/morbidities. The composite outcome was significantly higher in same-sex than in opposite-sex twins (OR = 1.68; 95% CI = [1.09, 2.59]). This relationship was most pronounced in ART pairs (OR = 2.25; 95% CI = [1.02, 4.98]), with increased rates in one or both twins from male–male versus opposite-sex ART pairs (OR = 3.0; 95% CI = [1.07, 8.36]). Conclusion: Same-sex pairing was associated with higher mortality/morbidities in very preterm twins admitted to the NICU, and can be used in clinical practice to identify twins at higher risk of adverse neonatal outcomes.
Using photometry at just two wavelengths it is possible to fit a blackbody to the spectrum of infrared excess that is the signature of a debris disc. From this the location of the dust can be inferred. However, it is well known that dust in debris discs is not a perfect blackbody. By resolving debris discs we can find the actual location of the dust and compare this to that inferred from the blackbody fit. Using the Herschel Space Observatory we resolved many systems as part of the DEBRIS survey. Here we discuss a sample of 9 discs surrounding A stars and find that the discs are actually located between 1 and 2.5 times further from their star than predicted by blackbody fits to the spectral energy distribution (SED). The variation in this ratio is due to differences in stellar luminosities, location of the dust, size distribution and composition of the dust.
We report the growth of silicon nanowires by plasma assisted metal organic chemical vapor deposition. Silicon nanowires grew as three-dimensional networks in which electrical charges and heat can travel over the distance much longer than the mean length of the constituent nanowires. We studied the dependence of thermoelectric properties on two factors; nominal doping concentrations and geometrical factors within the silicon nanowire networks. The silicon nanowire networks show Seebeck coefficients comparable with that of bulk silicon for a given nominal doping concentration, allowing us to control Seebeck coefficients by tuning the doping concentrations. Rather than studying single nanowires, we chose networks of nanowires formed densely across large areas required for large scale production. We also studied the role played by intersections where multiple nanowires were fused to form the nanowire networks. Structural analysis, transport measurement, and modeling based on finite-element analysis were carried out to obtain insights of physical properties at the intersections. Understanding these physical properties of three-dimensional nanowire networks will advance the development of thermoelectric devices.
Background: Mindfulness-based Cognitive Therapy (MBCT) is a relapse prevention treatment for major depressive disorder. Method: An observational clinical audit of 39 participants explored the long-term effects of MBCT using standardized measures of depression (BDI-II), rumination (RSS), and mindfulness (MAAS). Results: MBCT was associated with statistically significant reductions in depression from pre to post treatment. Gains were maintained over time (Group 1, 1–12 months, p = .002; Group 2, 13–24 months, p = .001; Group 3, 25–34 months, p = .04). Depression scores in Group 3 did begin to worsen, yet were still within the mild range of the BDI-II. Treatment variables such as attendance at “booster” sessions and ongoing mindfulness practice correlated with better depression outcomes (p = .003 and p = .03 respectively). There was a strong negative correlation between rumination and mindful attention (p < .001), consistent with a proposed mechanism of metacognition in the efficacy of MBCT. Conclusion: It is suggested that ongoing MBCT skills and practice may be important for relapse prevention over the longer term. Larger randomized studies of the mechanisms of MBCT with longer follow-up periods are recommended.
Background: This study examined characteristics of members of the public who self-referred and the effectiveness of psycho-educational CBT self-confidence workshops when run in routine practice. Method: Repeated measures were employed at pre- and post-workshop stages. Results: Of the 56 members of the general public who self-referred to the workshops, 70% were above the clinical cut-offs for Global Distress (CORE OM) and 86% were above the clinical cut offs for depression symptomatology (CES-D). Follow up data (n = 31) showed significant reduction in self-reported distress and depression at 4-week follow-up. A further analysis showed that those whose scores were above the clinical threshold at initial presentation benefited most but those with scores below the threshold did not seem to benefit. Conclusions: This study demonstrates that psycho-educational CBT workshops attract those with high levels of distress and depression, and have potential as a cost effective means of disseminating psychological interventions.