Greater Manchester community health needs assessment, June 2013

Needs assessment providing data and statistics on health related demographics and issues in the Manchester Health Service Area (HAS), as well as four strategic imperatives for health improvement

Depressive Symptoms and Addictive Behaviors in Young Adults After Childhood Trauma: The Mediating Role of Personality Organization and Despair

Background: There is substantial evidence that traumatic experiences in childhood increase the likelihood of mood pathology and addictive behaviors in adolescence and young adulthood. Furthermore, both forms of psychopathology have been linked to deficiencies in personality organization and a common primary emotion core. In this study, we intended to further investigate these interactions by assuming a mediating role of personality organization and despair regarding the relationship between childhood trauma and psychiatric symptom burden later in life. Methods: A total sample of 500 young adults (Age: M = 26; SD = 5.51; 63.2% female) were investigated. Structural Equation Modeling was applied in order to investigate the pathways between the latent variables Childhood Trauma, Structural Deficit, Despair (comprised of the primary emotions SEEKING and SADNESS), as well as symptoms of addiction and depression. Results: The results indicate that the influence of Childhood Trauma on Addictive Behaviors was mediated by Structural Deficit (p < 0.01), whereas its influence on Depressive Symptoms was mediated by Despair (decreased SEEKING and increased SADNESS) (p < 0.01). Furthermore, Addictive Behaviors seemed to be stronger represented in males (p < 0.001). The final model was able to explain 39% of the variance of Addictive Behaviors and 85% of the variance of Depressive Symptoms. Discussion: The findings underline the importance of early experiences in the development of adult affective and personality functioning, which is linked to the development of psychiatric disorders. Regarding clinical practice, addiction treatment might focus on the improvement of personality organization, while treatment of depressed patients should primarily emphasize the restructuring of dysfunctional primary emotion dispositions.© 2018 Fuchshuber, Hiebler-Ragger, Kresse, Kapfhammer and Unterraine

Do Primary Emotions Predict Psychopathological Symptoms? A Multigroup Path Analysis

Background: Research involving animal models has repeatedly proposed dysregulations in subcortically rooted affective systems as a crucial etiological factor in the development of a variety of psychiatric disorders. However, empirical studies with human participants testing these hypotheses have been sparse. Associations between primary emotions systems and different psychiatric symptoms were investigated in order to gain insights into the influence of evolutionary-rooted primary emotions on psychopathology. Material and Methods: The community sample included 616 adults (61.9% female). 243 reported a psychiatric lifetime diagnosis. By applying path analysis, we estimated paths between SEEKING, ANGER, FEAR, SADNESS, CARE, and PLAY (Affective Neuroscience Personality Scales; ANPS) and symptoms of substance abuse (Alcohol, Smoking, and Substance Involvement Screening Test; ASSIST) as well as depression, anxiety, and somatization (Brief Symptom Inventory; BSI-18). To examine the moderator effects of gender and psychiatric lifetime diagnosis, multigroup analysis was applied. Results: Substance abuse was associated with male sex (β = −.25), SADNESS (β = .25), and ANGER (β = .10). Depression was associated with SADNESS (β = .53), FEAR (β = .10), SEEKING (β = −.10), and PLAY (β = −.15). Anxiety was linked to SADNESS (β = .33), FEAR (β = .21) and PLAY (β = −.10). Somatization was associated with SADNESS (β = .26) and PLAY (β = −.12; all p .01). The model explained 14% of the variance of substance abuse, 52% of depression, 32% of anxiety, and 14% of somatization. Conclusions: The results further our understanding of the differential role of primary emotions in the development of psychopathology. In this, the general assumption that primary emotion functioning might be a valuable target in mental health care is underlined.© 2019 Fuchshuber, Hiebler-Ragger, Kresse, Kapfhammer and Unterraine

EXAFS study of sputtered Co/Al multilayers by electron detection: Structural difference due to deposition condition

EXAFS measurements and x-ray diffraction analysis have been made on magnetron sputtered Co-Al multilayers with modulation wavelengths of 1 to 2 monolayers and sputtering Ar gas pressure of 3 to 7 mTorr. X-ray diffraction results cannot clearly identify the phases present in the samples because the major diffraction peaks of different phases overlap. Preliminary analysis of the EXAFS data shows that Co atoms exist in two or more different phases, i.e., {alpha}-Co, CoAl(CsCl type), and possibly a solid solution of Co and Al with some Co atoms occupying the substitutional sites of fcc Al. 4 refs., 3 figs., 1 tab

WAO-ARIA consensus on chronic cough - Part III: Management strategies in primary and cough-specialty care. Updates inCOVID-19

Chronic cough management necessitates a clear integrated care pathway approach. Primary care physicians initially encounter the majority of chronic cough patients, yet their role in proper management can prove challenging due to limited access to advanced diagnostic testing. A multidisciplinary approach involving otolaryngologists and chest physicians, allergists, and gastroenterologists, among others, is central to the optimal diagnosis and treatment of conditions which underly or worsen cough. These include infectious and inflammatory, upper and lower airway pathologies, or gastro-esophageal reflux. Despite the wide armamentarium of ancillary testing conducted in cough multidisciplinary care, such management can improve cough but seldom resolves it completely. This can be due partly to the limited data on the role of tests (eg, spirometry, exhaled nitric oxide), as well as classical pharmacotherapy conducted in multidisciplinary specialties for chronic cough. Other important factors include presence of multiple concomitant cough trigger mechanisms and the central neuronal complexity of chronic cough. Subsequent management conducted by cough specialists aims at control of cough refractory to prior interventions and includes cough-specific behavioral counseling and pharmacotherapy with neuromodulators, among others. Preliminary data on the role of neuromodulators in a proof-of-concept manner are encouraging but lack strong evidence on efficacy and safety.The World Allergy Organization (WAO)/Allergic Rhinitis and its Impact on Asthma (ARIA) Joint Committee on Chronic Cough reviewed the recent literature on management of chronic cough in primary, multidisciplinary, and cough-specialty care. Knowledge gaps in diagnostic testing, classical and neuromodulator pharmacotherapy, in addition to behavioral therapy of chronic cough were also analyzed.This third part of the WAO/ARIA consensus on chronic cough suggests a management algorithm of chronic cough in an integrated care pathway approach. Insights into the inherent limitations of multidisciplinary cough diagnostic testing, efficacy and safety of currently available antitussive pharmacotherapy, or the recently recognized behavioral therapy, can significantly improve the standards of care in patients with chronic cough