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Cognitive development after schizophrenia onset can be shaped by interventions such as cognitive remediation, yet no study to date has investigated whether patterns of early behavioral development may predict later cognitive changes following intervention. We therefore investigated the extent to which premorbid adjustment trajectories predict cognitive remediation gains in schizophrenia.
Methods
In a total sample of 215 participants (170 first-episode schizophrenia participants and 45 controls), we classified premorbid functioning trajectories from childhood through late adolescence using the Cannon-Spoor Premorbid Adjustment Scale. For the 62 schizophrenia participants who underwent 6 months of computer-assisted, bottom-up cognitive remediation interventions, we identified MATRICS Consensus Cognitive Battery scores for which participants demonstrated mean changes after intervention, then evaluated whether developmental trajectories predicted these changes.
Results
Growth mixture models supported three premorbid functioning trajectories: stable-good, deteriorating, and stable-poor adjustment. Schizophrenia participants demonstrated significant cognitive remediation gains in processing speed, verbal learning, and overall cognition. Notably, participants with stable-poor trajectories demonstrated significantly greater improvements in processing speed compared to participants with deteriorating trajectories.
Conclusions
This is the first study to our knowledge to characterize the associations between premorbid functioning trajectories and cognitive remediation gains after schizophrenia onset, indicating that 6 months of bottom-up cognitive remediation appears to be sufficient to yield a full standard deviation gain in processing speed for individuals with early, enduring functioning difficulties. Our findings highlight the connection between trajectories of premorbid and postmorbid functioning in schizophrenia and emphasize the utility of considering the lifespan developmental course in personalizing therapeutic interventions.
A subset of events within the UK Government Events Research Programme (ERP), developed to examine the risk of transmission of COVID-19 from attendance at events, was examined to explore the public health impact of holding mass sporting events. We used contact tracing data routinely collected through telephone interviews and online questionnaires, to describe the potential public health impact of the large sporting and cultural events on potential transmission and incidence of COVID-19. Data from the EURO 2020 matches hosted at Wembley identified very high numbers of individuals who tested positive for COVID-19 and were traced through NHS Test & Trace. This included both individuals who were potentially infectious (3036) and those who acquired their infection during the time of the Final (6376). This is in contrast with the All England Lawn Tennis Championships at Wimbledon, where there were similar number of spectators and venue capacity but there were lower total numbers of potentially infectious cases (299) and potentially acquired cases (582). While the infections associated with the EURO 2020 event may be attributed to a set of socio-cultural circumstances which are unlikely to be replicated for the forthcoming sporting season, other aspects may be important to consider including mitigations for spectators to consider such as face coverings when travelling to and from events, minimising crowding in poorly ventilated indoor spaces such as bars and pubs where people may congregate to watch events, and reducing the risk of aerosol exposure through requesting that individuals avoid shouting and chanting in large groups in enclosed spaces.
One of the most alarming trends of the past decade has been the rise in authoritarianism and the growing support of strongman politics among citizens of democratic regimes. College instructors have a unique opportunity to challenge such thinking at a time when many of their students are still forming their political beliefs. Using a game, instructors not only can show students the perils of authoritarianism, they also can potentially expand students’ appreciation of democracy. This article describes a game suitable for this purpose. Students take on the role of workers, soldiers, and rulers in a military dictatorship to learn about the “guns-and-butter tradeoff” and authoritarian uncertainty.
The present study examined the association between high-quality diet (using the Mediterranean diet (MD) as an example) and well-being cross-sectionally and prospectively in Spanish children and adolescents. Participants included 533 children and 987 adolescents at baseline and 527 children and 798 adolescents at 2-year follow-up, included in the UP&DOWN study (follow-up in schoolchildren and adolescents with and without Down’s syndrome). The present study excluded participants with Down’s syndrome. Adherence to an MD was assessed using the KIDMED index. Well-being was measured using the Positive and Negative Affect Schedule and the KIDSCREEN-10 questionnaire. Associations between MD adherence and well-being were assessed using multi-level, mixed-effects linear regression. At baseline, MD adherence was positively related to health-related quality of life in secondary school girls and boys (β=0·41, se 0·10, P<0·001; β=0·46, se 0·10, P<0·001, respectively) and to positive affect in secondary school girls and boys (β=0·16, se 0·05, P=0·006; β=0·20, se 0·05, P<0·001, respectively) and in primary school boys (β=0·20, se 0·08, P=0·019). At 2-year follow-up, MD adherence was negatively related to negative affect in secondary school adolescent girls and boys (β=–0·15, se 0·07, P=0·047; β=–0·16, se 0·06, P=0·019, respectively), and MD adherence was associated with higher positive affect scores in secondary school girls (β=0·30, se 0·06, P<0·001) and in primary school boys (β=0·20, se 0·09, P=0·023). However, MD adherence at baseline did not predict well-being indicators at 2-year follow-up. In conclusion, higher MD adherence was found to behave as a protective factor for positive well-being in cross-sectional analysis.
High Na intake and chronically elevated cortisol levels are independently associated with the development of chronic diseases. In adults, high Na intake is associated with high levels of urinary cortisol. We aimed to determine the association between urinary Na and K and urinary cortisol in a cross-sectional sample of Australian schoolchildren and their mothers. Participants were a sample of Australian children (n 120) and their mothers (n 100) recruited through primary schools. We assessed Na, K, free cortisol and cortisol metabolites in one 24 h urine collection. Associations between 24 h urinary electrolytes and 24 h urinary cortisol were assessed using multilevel mixed-effects linear regression models. In children, urinary Na was positively associated with urinary free cortisol (β=0·31, 95 % CI 0·19, 0·44) and urinary cortisol metabolites (β=0·006, 95 % CI 0·002, 0·010). Positive associations were also observed between urinary K and urinary free cortisol (β=0·65, 95 % CI 0·23, 1·07) and urinary cortisol metabolites (β=0·02, 95 % CI 0·03, 0·031). In mothers, urinary Na was positively associated with urinary free cortisol (β=0·23, 95 % CI 0·01, 0·50) and urinary cortisol metabolites (β=0·008, 95 % CI 0·0007, 0·016). Our findings show that daily Na and K intake were positively associated with cortisol production in children and their mothers. Investigation of the mechanisms involved and the potential impact of Na reduction on cortisol levels in these populations is warranted.
Dairy cows grazing pasture and milked using automated milking systems (AMS) have lower milking frequencies than indoor fed cows milked using AMS. Therefore, milk recording intervals used for herd testing indoor fed cows may not be suitable for cows on pasture based farms. We hypothesised that accurate standardised 24 h estimates could be determined for AMS herds with milk recording intervals of less than the Gold Standard (48 hs), but that the optimum milk recording interval would depend on the herd average for milking frequency. The Gold Standard protocol was applied on five commercial dairy farms with AMS, between December 2011 and February 2013. From 12 milk recording test periods, involving 2211 cow-test days and 8049 cow milkings, standardised 24 h estimates for milk volume and milk composition were calculated for the Gold Standard protocol and compared with those collected during nine alternative sampling scenarios, including six shorter sampling periods and three in which a fixed number of milk samples per cow were collected. Results infer a 48 h milk recording protocol is unnecessarily long for collecting accurate estimates during milk recording on pasture based AMS farms. Collection of two milk samples only per cow was optimal in terms of high concordance correlation coefficients for milk volume and components and a low proportion of missed cow-test days. Further research is required to determine the effects of diurnal variations in milk composition on standardised 24 h estimates for milk volume and components, before a protocol based on a fixed number of samples could be considered. Based on the results of this study New Zealand have adopted a split protocol for herd testing based on the average milking frequency for the herd (NZ Herd Test Standard 8100:2015).
Vertebrate microfossils are commonly present as minor constituents of acid-etched limestone residues in the Lochkovian (Lower Devonian). This paper describes the fish taxa from the Simpson Park Range section at Coal Canyon, central Nevada. These include thelodont scales of the family Nikoliviidae; heterostracan scales; acanthodian scales, platelets, and spines of Nostolepis type, Gomphonchus type, Acanthodes type, Machaeracanthus type, and climatiid type; placoderm scales of buchanosteid and radotinid types; and the shark, Polymerolepis whitei.
Phosphatic microfossils including copious microvertebrates and conodont elements indicative of the upper Icriodella discreta–Icriodella deflecta Zone (Aeronian) are found in a single bed of the Hendricks Formation, Burnt Bluff Group, Sturgeon Bay, Wisconsin. Scales of thelodonts, including Loganellia sp. cf. Loganellia siberica Karajute-Talimaa, 1978, and rare Valyalepis crista Turner (in Turner and Nowlan, 1995) predominate among the microvertebrate remains. Most scales are referred to Zuegelepis potanus Turner new genus and species. Associated with the thelodont scales are rare phosphatic fragments of questionable dermal “bone” and scales, possibly of heterostracan origin. Thelodont scales are also found in the Hendricks Formation at Fayette State Park, Michigan and in the subsurface Byron Formation (Burnt Bluff Group) in Schoolcraft County, Michigan.
Rare scales of agnathan thelodonts Paralogania ludlowiensis and Thelodus sp. cf. T. parvidens, or alternatively Thelodus macintoshi, and acanthodian fishes Nostolepis striata, Gomphonchus sp., Gomphonchoporus sp. aff. G. hoppei, and Machaeraporus stonehousensis (Legault) n. gen., plus acanthodian fin spines, teeth and tooth whorls have been identified from the upper Moydart and Stonehouse formations near Arisaig, Nova Scotia. The assemblage agrees well with the late Silurian (uppermost Ludlow–Přídolí) age assigned to these strata based on invertebrate assemblages, and the vertebrate taxa show affinity with British and Baltic faunas of this age. All vertebrate-bearing strata were deposited in various positions off the western shores of the Avalonia terrane during or after its collision with Laurentia.
Wright Valley, Victoria Land contains numerous aquatic habitats suitable for the growth of algae in summer. Excepting diatoms and lichen phycobionts, algal diversity and distribution in the valley was documented. Using cultures and environmental cloning eight cyanobacterial and 14 eukaryotic species were revealed. The cyanobacterium Microcoleus vaginatus and the chlorophycean Chlorococcum sp. 1 were the most common, both occurring in more than one habitat (ponds, soils or streams). Ponds harboured the most diverse communities. Habitat specialization was rare. Chlamydomonads were not found outside ponds, but species capable of zoospore production were able to colonize ponds and soils. Nostocalean cyanobacteria were not detected. Results suggest dispersal within and between valleys, with little evidence of Antarctic endemism. All but one cyanobacterium with similar internally transcribed spacer (ITS) length to clones from Miers Valley proved to be different species when 16S rRNA gene sequences were also considered; thus, ITS length is unreliable for assessing identity and biogeography of these cyanobacteria. Comparison with a 454 16S rRNA gene soil dataset from Wright Valley indicated the occurrence of only one of the cyanobacterial species, the distribution of which may be limited by salinity.
To investigate the attitudes to health and work of general practitioners (GPs) with training in occupational medicine (OM) compared with non-OM trained GPs, since the introduction of the fit note.
Background
Changes to the UK sickness certification system since 2010 and the introduction of the fit note required GPs to change their focus to what patients can do, rather than what they cannot do in relation to work. In an effort to reduce the UK sickness absence burden, GPs completion of the fit note should help to keep people in work, or assist patients to return to work as quickly as possible after a period of absence.
Methods
Questionnaire data were collected via the 7th National General Practitioner Worklife Survey.
Findings
Results indicate that responses from GPs who had undertaken training in OM, and GPs having received some form of work and health training in the 12-month period before the study were associated with significantly more positive attitudes to patients’ returning to work and to the fit note. This study reveals evidence of a difference between trained and non-trained GPs in their attitude to the fit note, and to work and health generally. Further work investigating the effect of specific training in OM on the management and recognition of ill-health by GPs is recommended.
Rubberlike insect cuticle is a light fibrous composite, which exhibits great deformability and long-range elasticity due to the presence of a large amount of the elastomeric protein resilin. The presence of resilin in specific locations in the insect body leads to the assumption that its main function is loss-free storage of energy. Rubberlike cuticle was identified, for the first time, in the femur base of the sand field cricket, Gryllus firmus, using fluorescence microscopy and various staining methods. Dynamic nanoindentation testing was then used to investigate the differences in the mechanical properties of rubberlike cuticle between males and females and wing morphs of this species. Significant changes in storage, loss moduli, and resilience were captured between female wing morphs. The results provide insight into the structure–function relations associated with the properties of insect joints from different morphs and genders.
Background: Recognition of bioterrorism-related infections by hospital and emergency department clinicians may be the first line of defense in a bioterrorist attack.
Methods: We identified unexplained infectious deaths consistent with the clinical presentation of anthrax, tularemia, smallpox, and botulism using Connecticut death certificates and hospital chart information. Minimum work-up criteria were established to assess the completeness of diagnostic testing.
Results: Of 4558 unexplained infectious deaths, 133 were consistent with anthrax (2.9%) and 6 (0.13%) with tularemia. None were consistent with smallpox or botulism. No deaths had anthrax or tularemia listed in the differential diagnosis or had disease-specific serology performed. Minimum work-up criteria were met for only 53% of cases.
Conclusions: Except for anthrax, few unexplained deaths in Connecticut could possibly be the result of the bioterrorism agents studied. In 47% of deaths from illnesses that could be anthrax, the diagnosis would likely have been missed. As of 2004, Connecticut physicians were not well prepared to intentionally or incidentally diagnose initial cases of anthrax or tularemia. More effective clinician education and surveillance strategies are needed to minimize the potential to miss initial cases in a bioterrorism attack. (Disaster Med Public Health Preparedness. 2008;2:87–94)