An exploratory study of midlife transition in South Africa : in search of the midlife crisis

Strong opposing views exist with the popularly held notion that a midlife crisis is a normative phenomenon whilst a number of international researchers assert that the evidence shows the opposite to be true. It is nevertheless acknowledged that the psychology of midlife was one of the least researched areas internationally until the 1990s when certain aspects of midlife were investigated in the United States. Findings from these studies did not include the impact of a multiplicity of factors in combination at midlife. A new approach to the study of the life course using a combination model taking account of the influence of societal structures as well as the interplay between parts has been suggested. Such an approach to midlife transition and crisis research is not known to have taken place in South Africa or internationally. A conceptual model of midlife transition and crisis was constructed from known research and relevant literature and tested using a sample of 220 individuals aged between 30 and 65. The validity of the model was established and a methodologically sound measuring instrument was validated as a more accurate measurement of midlife crisis than a self-described experience. Two factors provisionally named stagnation and death and aging anxiety were found to exist. A true midlife crisis was experienced by a minority of individuals (IS percent) but an additional 31 percent had a troublesome but manageable experience. A neurotic disposition. the absence of good parental relationships, and the use of inappropriate coping skills such as wishful thinking were in combination related to high scores on the midlife crisis scales. A qualitative study revealed that over 90 percent of respondents were able to define a midlife crisis accurately although they tended to overstate the occurrence thereof. This replicates the research findings in the United States. Stagnation was experienced more acutely by individuals aged between 40 and 50 years whilst death and aging anxiety was the primary experience for those over 50 years. The validated conceptual model and measuring instruments can be used by therapists and coaches to facilitate the counselling or coaching process with clients experiencing midlife crisis.PsychologyD. Comm. (Consulting Psychology

Potential use of clinical polygenic risk scores in psychiatry – ethical implications and communicating high polygenic risk

Abstract Psychiatric disorders present distinct clinical challenges which are partly attributable to their multifactorial aetiology and the absence of laboratory tests that can be used to confirm diagnosis or predict risk. Psychiatric disorders are highly heritable, but also polygenic, with genetic risk conferred by interactions between thousands of variants of small effect that can be summarized in a polygenic risk score. We discuss four areas in which the use of polygenic risk scores in psychiatric research and clinical contexts could have ethical implications. First, there is concern that clinical use of polygenic risk scores may exacerbate existing health inequities. Second, research findings regarding polygenic risk could be misinterpreted in stigmatising or discriminatory ways. Third, there are concerns associated with testing minors as well as eugenics concerns elicited by prenatal polygenic risk testing. Fourth, potential challenges that could arise with the feedback and interpretation of high polygenic risk for a psychiatric disorder would require consideration. While there would be extensive overlap with the challenges of feeding back genetic findings in general, the potential clinical use of polygenic risk scoring warrants discussion in its own right, given the recency of this possibility. To this end, we discuss how lay interpretations of risk and genetic information could intersect. Consideration of these factors would be necessary for ensuring effective and constructive communication and interpretation of polygenic risk information which, in turn, could have implications for the uptake of any therapeutic recommendations. Recent advances in polygenic risk scoring have major implications for its clinical potential, however, care should be taken to ensure that communication of polygenic risk does not feed into problematic assumptions regarding mental disorders or support reductive interpretations

A pilot feasibility trial of alcohol screening and brief intervention in the police custody setting (ACCEPT): study protocol for a cluster randomised controlled trial

BACKGROUND: There is evidence of an association between alcohol use and offending behaviour and around a quarter of police time is spent on alcohol-related incidents. Police custody, therefore, provides an important opportunity to intervene. This pilot trial aims to investigate whether a definitive evaluation of screening and brief interventions aimed at reducing risky drinking in arrestees is acceptable and feasible in the custody suite setting. METHODS: Screening will be carried out by trained detention officers or drug and alcohol workers in four police forces across two geographical areas (North East and South West England). Detention officers (or drug and alcohol workers) will be cluster randomised to one of three conditions: screening only (control group), screening followed immediately by 10 min of manualised brief structured advice delivered by the individual responsible for screening (intervention 1) or screening followed by 10 min of manualised brief structured advice delivered by the individual responsible for screening plus the offer of a subsequent 20-min session of behaviour change counselling delivered by a trained alcohol health worker (intervention 2). Participants will be arrestees aged 18+ who screen positive on the Alcohol Use Disorders Identification Test. Participants will be followed up at 6 and 12 months post-intervention. An embedded qualitative process evaluation will explore acceptability of alcohol screening and brief intervention to staff and arrestees as well as facilitators and barriers to the delivery of such approaches in this setting. RESULTS: Recruitment is currently underway and due to end May 2015. CONCLUSION: Results from this pilot trial will determine if a definitive evaluation is possible in the future and will provide stakeholder input to its design. TRIAL REGISTRATION: Reference number: ISRCTN89291046

Efficiency of primary saliva secretion: an analysis of parameter dependence in dynamic single-cell and acinus models, with application to aquaporin knockout studies

Secretion from the salivary glands is driven by osmosis following the establishment of osmotic gradients between the lumen, the cell and the interstitium by active ion transport. We consider a dynamic model of osmotically driven primary saliva secretion and use singular perturbation approaches and scaling assumptions to reduce the model. Our analysis shows that isosmotic secretion is the most efficient secretion regime and that this holds for single isolated cells and for multiple cells assembled into an acinus. For typical parameter variations, we rule out any significant synergistic effect on total water secretion of an acinar arrangement of cells about a single shared lumen. Conditions for the attainment of isosmotic secretion are considered, and we derive an expression for how the concentration gradient between the interstitium and the lumen scales with water- and chloride-transport parameters. Aquaporin knockout studies are interpreted in the context of our analysis and further investigated using simulations of transport efficiency with different membrane water permeabilities. We conclude that recent claims that aquaporin knockout studies can be interpreted as evidence against a simple osmotic mechanism are not supported by our work. Many of the results that we obtain are independent of specific transporter details, and our analysis can be easily extended to apply to models that use other proposed ionic mechanisms of saliva secretion

Cross-sectional measures and modelled estimates of blood alcohol levels in UK nightlife and their relationships with drinking behaviours and observed signs of inebriation

<p>Abstract</p> <p>Background</p> <p>Management of nightlife in UK cities focuses on creating safe places for individuals to drink. Little is known about intoxication levels as measuring total alcohol consumption on nights out is complicated by early evening interviews missing subsequent consumption and later interviews risking individuals being too drunk to recall consumption or participate at all. Here we assess mixed survey and modelling techniques as a methodological approach to examining these issues.</p> <p>Methods</p> <p>Interviews with a cross sectional sample of nightlife patrons (n = 214) recruited at different locations in three cities established alcohol consumption patterns up to the point of interview, self-assessed drunkenness and intended drinking patterns throughout the remaining night out. Researchers observed individuals' behaviours to independently assess drunkenness. Breath alcohol tests and general linear modelling were used to model blood alcohol levels at participants' expected time of leaving nightlife settings.</p> <p>Results</p> <p>At interview 49.53% of individuals regarded themselves as drunk and 79.43% intended to consume more alcohol before returning home, with around one in ten individuals (15.38% males; 4.35% females) intending to consume >40 units (equal to 400 mls of pure alcohol). Self-assessed drunkenness, researcher observed measures of sobriety and blood alcohol levels all correlated well. Modelled estimates for blood alcohol at time of going home suggested that 71.68% of males would be over 0.15%BAC (gms alcohol/100 mls blood). Higher blood alcohol levels were related to drinking later into the night.</p> <p>Conclusions</p> <p>UK nightlife has used substantive health and judicial resources with the aim of creating safer and later drinking environments. Survey and modelling techniques together can help characterise the condition of drinkers when using and leaving these settings. Here such methods identified patrons as routinely getting drunk, with risks of drunkenness increasing over later nights. Without preventing drunkenness and sales to intoxicated individuals, extended drinking hours can simply act as havens for drunks. A public health approach to nightlife is needed to better understand and take into account the chronic effects of drunkenness, the damages arising after drunk individuals leave city centres and the costs of people avoiding drunken city centres at night.</p

The effects of Title I funds in improving reading and math achievement in selected Tennessee middle schools

In an ex post facto causal-comparative research design, this study investigated the effectiveness of Title I funds in improving achievement of students in selected middle schools in the state of Tennessee. Title I schools were compared to schools with a population of low socioeconomic students greater than 40% therefore were eligible for Title I funds but chose not to accept the funds. Reading and math Tennessee Comprehensive Assessment Program (TCAP) scores were utilized for this study over a two year period (2008–2009 and 2009–2010). The independent variable for the study was Title I school status. The dependent variable was TCAP reading and math scores. In this quantitative study, comprised of two parts, TCAP achievement scores were analyzed. In part one of the study, a sample of 20 Title I schools\u27 TCAP scores were compared with a sample of 20 non-Title I schools\u27 TCAP scores. In part two of the study, a case study was completed in which individual student scores were compared between a sample of students who attended a Title I school and another sample of students who did not attend a Title I school. For all six hypotheses, ANCOVAs were performed at the .05 level of significance, and all hypotheses were retained. No statistically significant differences were found in reading and math among extraneous variables of gender and economically disadvantaged status. The results of the study showed that students who attended a Title I school achieved as well as students who did not attend a Title I school. One recommendation for practice is that Title I funds be used for personnel that work directly with students. Another recommendation was that Title I funds be awarded to schools which successfully improve student achievement on standardized tests. A recommendation for further research is that a longitudinal project involving mixed methods research should be considered. This research should include interviews with Title I teachers and staff members and analysis of programs used within successful Title I schools. Further research should be conducted in a more ethnically diverse setting than available in Tennessee middle schools

Who are the real “first offenders”?

Drink driving causes more fatal crashes than any other single factor on Australian roads, with a third of crashes having alcohol as a contributing factor. In recent years there has been a plateau in the numbers of drink drivers apprehended by RBT, and around 12% of the general population in self report surveys admit to drinking and driving. There is limited information about the first offender group, particularly the subgroup of these offenders who admit to prior drink driving, the offence therefore being the “first time caught”. This research focuses on the differences between those who report drink driving prior to apprehension for the offence and those who don’t. Methods: 201 first time drink driving offenders were interviewed at the time of their court appearance. Information was collected on socio-demographic variables, driving behaviour, method of apprehension, offence information, alcohol use and self reported previous drink driving. Results: 78% of respondents reported that they had driven over the legal alcohol limit in the 6 months prior to the offence. Analyses revealed that those offenders who had driven over the limit previously without being caught were more likely to be younger and have an issue with risky drinking. When all variables were taken into account in a multivariate model using logistic regression, only risky drinking emerged as significantly related to past drink driving. High risk drinkers were 4.8 times more likely to report having driven over the limit without being apprehended in the previous 6 months. Conclusion: The majority of first offenders are those who are “first time apprehended” rather than “first time drink drivers”. Having an understanding of the differences between these groups may alter the focus of educational or rehabilitation countermeasures. This research is part of a larger project aiming to target first time apprehended offenders for tailored intervention