Integrating Assertive Community Treatment and Illness Management and Recovery for Consumers with Severe Mental Illness

This study examined the integration of two evidence-based practices for adults with severe mental illness: Assertive community treatment (ACT) and illness management and recovery (IMR) with peer specialists as IMR practitioners. Two of four ACT teams were randomly assigned to implement IMR. Over 2 years, the ACT–IMR teams achieved moderate fidelity to the IMR model, but low penetration rates: 47 (25.7%) consumers participated in any IMR sessions and 7 (3.8%) completed the program during the study period. Overall, there were no differences in consumer outcomes at the ACT team level; however, consumers exposed to IMR showed reduced hospital use over time

Natural Inflation: Particle Physics Models, Power Law Spectra for Large Scale Structure, and Constraints from COBE

A pseudo-Nambu-Goldstone boson, with a potential of the form $V(\phi) = \Lambda^4[1 \pm \cos(\phi/f)], naturally gives rise to inflation if$f \sim M_{Pl}$and$\Lambda \sim M_{GUT}$. We show how this can arise in technicolor-like and superstring models, and work out an explicit string example in the context of multiple gaugino condensation models. We study the cosmology of this model in detail, and find that sufficient reheating to ensure that baryogenesis can take place requires$f > 0.3 M_{Pl}$. The primordial density fluctuation spectrum generated is a non-scale-invariant power law,$P(k) \propto k^{n_s}$, with$n_s \simeq 1 - (M^2_{Pl}/8\pi f^2)$, leading to more power on large length scales than the$n_s = 1$Harrison-Zeldovich spectrum. The standard CDM model with$0 \la n_s \la 0.6-0.7$could in principle explain the large-scale clustering observed in the APM and IRAS galaxy surveys as well as large-scale flows, but the COBE microwave anisotropy implies such low amplitudes (or high bias factors,$b>2$) for these CDM models that galaxy formation occurs too late to be viable; combining COBE with sufficiently early galaxy formation or the large-scale flows leads to$n_s >0.6$, or$f > 0.3 M_{Pl}$as well. For extended and power law inflation models, this constraint is even tighter,$n_s > 0.7$; combined with other bounds on large bubbles in extended inflation, this leaves little room for most extended models.Comment: 42 pages, (12 figures not included but available from the authors

Molecular Hydrogen in the Ring Nebula: Clumpy Photodissociation Regions

Article DOI: 10.1086/345911 Article Stable URL: http://www.jstor.org/stable/10.1086/345911We present a 0 .65 resolution H2 1-0 S(1) 2.122 mm image of the Ring Nebula (NGC 6720), which was taken with the Near Infrared Imager at the WIYN 3.5 m telescope on Kitt Peak. The high resolution of the H2 observation is sufficient to reveal the finer structure of the molecular material in this nebula. The morphology of the molecular emission is compared to that of the ionized emission from the Ring Nebula as seen by the Hubble Space Telescope (HST; He ii, [O iii], and [N ii]), and it is clear that the dark clumps seen by HST match the locations of clumpy H2 emission, suggesting that these clumps are similar to the cometary knots seen in the Helix Nebula. As with the Helix, the clumpy H2 emission from the main ring of the Ring Nebula is contained within the optically bright ionized nebula, implying that the molecular gas is shielded inside dense condensations. Comparison of the observed H2 average surface brightnesses for the Ring Nebula [(1.5 ergs cm 2 s 1 sr 1] with time-dependent models of the expected H2 0.5)#10 4 emission from planetary nebulae (PNe) shows that it is consistent with H2 excitation in photodissociation regions (PDRs), confirming previous suggestions. Comparison of the Ring Nebula H2 emission with a younger PN, NGC 2346, and an older PN, the Helix Nebula, suggests an evolution in H2 surface brightness consistent with the time-dependent PDR models. Moreover, the knots of molecular gas appear to become more isolated as the PN evolves, consistent with optical studies of knots in PNe.A. K. S. was supported by NASA JPL 961504 and NASA STI 7898.02-96A. A. K. S. and M. M. were supported by NSF CAREER award AST 97-33697

QCD ghost f(T)-gravity model

Within the framework of modified teleparallel gravity, we reconstruct a f(T) model corresponding to the QCD ghost dark energy scenario. For a spatially flat FRW universe containing only the pressureless matter, we obtain the time evolution of the torsion scalar T (or the Hubble parameter). Then, we calculate the effective torsion equation of state parameter of the QCD ghost f(T)-gravity model as well as the deceleration parameter of the universe. Furthermore, we fit the model parameters by using the latest observational data including SNeIa, CMB and BAO data. We also check the viability of our model using a cosmographic analysis approach. Moreover, we investigate the validity of the generalized second law (GSL) of gravitational thermodynamics for our model. Finally, we point out the growth rate of matter density perturbation. We conclude that in QCD ghost f(T)-gravity model, the universe begins a matter dominated phase and approaches a de Sitter regime at late times, as expected. Also this model is consistent with current data, passes the cosmographic test, satisfies the GSL and fits the data of the growth factor well as the LCDM model.Comment: 19 pages, 9 figures, 2 tables. arXiv admin note: substantial text overlap with arXiv:1111.726

Self-reported colorectal cancer screening of Medicare beneficiaries in family medicine vs. internal medicine practices in the United States: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>The benefit of screening for decreasing the risk of death from colorectal cancer (CRC) has been shown, yet many patients in primary care are still not undergoing screening according to guidelines. There are known variations in delivery of preventive health care services among primary care physicians. This study compared self-reported CRC screening rates and patient awareness of the need for CRC screening of patients receiving care from family medicine (FPs) vs. internal medicine (internists) physicians.</p> <p>Methods</p> <p>Nationally representative sample of non-institutionalized beneficiaries who received medical care from FPs or internists in 2006 (using Medicare Current Beneficiary Survey). The main outcome was the percentage of patients screened in 2007. We also examined the percentage of patients offered screening.</p> <p>Results</p> <p>Patients of FPs, compared to those of internists, were less likely to have received an FOBT kit or undergone home FOBT, even after accounting for patients' characteristics. Compared to internists, FPs' patients were more likely to have heard of colonoscopy, but were less likely to receive a screening colonoscopy recommendation (18% vs. 27%), or undergo a colonoscopy (43% vs. 46%, adjusted odds ratios [AOR], 95% confidence interval [CI]-- 0.65, 0.51-0.81) or any CRC screening (52% vs. 60%, AOR, CI--0.80, 0.68-0.94). Among subgroups examined, higher income beneficiaries receiving care from internists had the highest screening rate (68%), while disabled beneficiaries receiving care from FPs had the lowest screening rate (34%).</p> <p>Conclusion</p> <p>Patients cared for by FPs had a lower rate of screening compared to those cared for by internists, despite equal or higher levels of awareness; a difference that remained statistically significant after accounting for socioeconomic status and access to healthcare. Both groups of patients remained below the national goal of 70 percent.</p

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Coccolithophores as proxy of seawater changes at orbital-to-millennial scale during middle Pleistocene Marine Isotope Stages 14-9 in North Atlantic core MD01-2446

midlatitude North Atlantic, to reconstruct climatically induced sea surface water conditions throughout Marine Isotope Stages (MIS) 14–9. The data are compared to new and available paleoenvironmental proxies from the same site as well as other nearby North Atlantic records that support the coccolithophore signature at glacial‐interglacial to millennial climate scale. Total coccolithophore absolute abundance increases during interglacials but abruptly drops during the colder glacial phases and deglaciations. Coccolithophore warm water taxa (wwt) indicate that MIS11c and MIS9e experienced warmer and more stable conditions throughout the whole photic zone compared to MIS13. MIS11 was a long‐lasting warmer and stable interglacial characterized by a climate optimum during MIS11c when a more prominent influence of the subtropical front at the site is inferred. The wwt pattern also suggests distinct interstadial and stadial events lasting about 4–10 kyr. The glacial increases of Gephyrocapsa margereli‐G. muellerae 3–4 µm along with higher values of Corg, additionally supported by the total alkenone abundance at Site U1313, indicate more productive surface waters, likely reflecting the migration of the polar front into the midlatitude North Atlantic. Distinctive peaks of G. margereli‐muellerae (>4 µm), C. pelagicus pelagicus , Neogloboquadrina pachyderma left coiling, and reworked nannofossils, combined with minima in total nannofossil accumulation rate, are tracers of Heinrich‐type events during MIS12 and MIS10. Additional Heinrich‐type events are suggested during MIS12 and MIS14 based on biotic proxies, and we discuss possible iceberg sources at these times. Our results improve the understanding of mid‐Brunhes paleoclimate and the impact on phytoplankton diversity in the midlatitude North Atlantic region.Provided by PTCRIS: 58282, C2007-FCT/319/2006info:eu-repo/semantics/publishedVersio

Genomics and metagenomics of trimethylamine-utilizing Archaea in the human gut microbiome

International audienceThe biological significance of Archaea in the human gut microbiota is largely unclear. We recently reported genomic and biochemical analyses of the Methanomassiliicoccales, a novel order of methanogenic Archaea dwelling in soil and the animal digestive tract. We now show that these Methanomassiliicoccales are present in published microbiome data sets from eight countries. They are represented by five Operational Taxonomic Units present in at least four cohorts and phylogenetically distributed into two clades. Genes for utilizing trimethylamine (TMA), a bacterial precursor to an atherosclerogenic human metabolite, were present in four of the six novel Methanomassiliicoccales genomes assembled from ELDERMET metagenomes. In addition to increased microbiota TMA production capacity in long-term residential care subjects, abundance of TMA-utilizing Methanomassiliicoccales correlated positively with bacterial gene count for TMA production and negatively with fecal TMA concentrations. The two large Methanomassiliicoccales clades have opposite correlations with host health status in the ELDERMET cohort and putative distinct genomic signatures for gut adaptation

Are Reports of Psychological Stress Higher in Occupational Studies? A Systematic Review across Occupational and Population Based Studies

This study was funded by the UK Ministry of Defence (MoD)

2D versus 3D human induced pluripotent stem cell-derived cultures for neurodegenerative disease modelling

Neurodegenerative diseases, such as Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease (HD) and amyotrophic lateral sclerosis (ALS), affect millions of people every year and so far, there are no therapeutic cures available. Even though animal and histological models have been of great aid in understanding disease mechanisms and identifying possible therapeutic strategies, in order to find disease-modifying solutions there is still a critical need for systems that can provide more predictive and physiologically relevant results. One possible avenue is the development of patient-derived models, e.g. by reprogramming patient somatic cells into human induced pluripotent stem cells (hiPSCs), which can then be differentiated into any cell type for modelling. These systems contain key genetic information from the donors, and therefore have enormous potential as tools in the investigation of pathological mechanisms underlying disease phenotype, and progression, as well as in drug testing platforms. hiPSCs have been widely cultured in 2D systems, but in order to mimic human brain complexity, 3D models have been proposed as a more advanced alternative. This review will focus on the use of patient-derived hiPSCs to model AD, PD, HD and ALS. In brief, we will cover the available stem cells, types of 2D and 3D culture systems, existing models for neurodegenerative diseases, obstacles to model these diseases in vitro, and current perspectives in the field