The relationship between childhood adversity and violence to others among individuals with psychosis: a review and meta-analysis

Background: There is a growing body of literature identifying a relationship between experiences of child abuse and symptoms of psychosis in adults. However, the impact of this relationship on risk of violence has not been systematically explored. Aims: This meta-analysis aimed to consider the influence of childhood abuse on the risk of violence amongst individuals with psychosis. Method: Five bibliographic databases and two grey literature resources were systematically searched to identify quantitative research which measured risk of violence and experiences of childhood maltreatment in individuals with psychosis. Risk of bias for each study was assessed under pre-defined criteria. Logged odds ratios were synthesised quantitatively in a meta-analysis. Results: A total of 6298 studies were identified, 11 of which were included in the final analysis (N = 2215), all studies were of a cross-sectional or case-control design. Individuals with psychotic illnesses who reported historical child maltreatment were at approximately twice the risk of perpetrating violence than patients who reported no early abuse (OR = 2.46 (95% CI = 1.91 – 3.16). There was no statistical heterogeneity between main effects (τ = 0.00; Χ² = 8.87, df = 10, p = 0.54, I² = 0%). Discussion: Risk assessments and interventions may benefit from considering the unique contribution of trauma to violence in this population. Future research considering the interaction between childhood experiences and other risk factors for violence in this population, including specific symptoms of psychosis, would inform the current findings. Findings are limited by the lack of longitudinal research in this area, and there was some evidence of publication bias

Role of Oxygen on Phase Stability, Precipitation, Deformation, and Oxidation in Pure Titanium and Beta Titanium Alloys

Titanium and its alloys exhibit many desirable properties, such as a high strength-to-weight ratio and excellent corrosion resistance, which result in their continued importance as structural materials particularly for aerospace and biomedical industries. However, titanium’s reactivity with oxygen presents significant challenges to mechanical performance, including embrittlement caused by oxygen in solid solution and fast oxidation during high temperature exposures. Oxygen is therefore typically considered a detrimental element for titanium alloys. Commercial alloys commonly require strict limits on oxygen impurities to prevent embrittlement and are used at relatively low service temperatures to prevent material loss by oxidation. These challenges present opportunities for titanium alloy development. Oxygen has been shown to modify phase formation and precipitation sequences in metastable beta titanium alloys containing high amounts of beta-stabilizing elements, which resulted in novel mechanical behavior suggestive of potential new application spaces. Regarding oxidation, while the development of protective coatings has shown significant reductions in oxidation kinetics for Ti alloys, limited understanding still exists on how alloying elements might provide protection. Consequently, this thesis is organized in two parts. First, it argues that oxygen is not always detrimental by providing advancements in our understanding of the role of oxygen as an alloying element in beta alloys. Second, when oxygen concentrations and oxidation need to be controlled, it details a possible approach to creating effective coatings using silicon. The role of oxygen was demonstrated in a model beta Ti-Nb alloy and commercial Ti-15-333 and Ti-15Mo alloys. Compositionally-graded microstructures were created using high temperature oxidation followed by ageing to understand oxygen’s influence on metastable omega and stable alpha phase precipitation kinetics and morphologies. Multi-scale microstructural characterization methods including scanning electron microscopy, transmission electron microscopy, wavelength dispersive spectroscopy, atom probe tomography, and micropillar compression were utilized to evaluate microstructural evolution and mechanical behavior as a function of oxygen content. Elevated oxygen levels induced morphology, number density, and size changes for the metastable omega phase and accelerated alpha nucleation rate. Notably, oxygen partitioning to omega during ageing resulted in increased resistance of omega to precipitate shearing and suppression of catastrophic failure during micropillar compression. While both oxygen and omega are known embrittlement risk factors, the stabilization of omega with oxygen leads to promising microstructures and mechanical properties. Furthermore, oxygen-induced refinement of alpha precipitates provides an additional pathway to obtain fine alpha laths that enable precipitation strengthening of beta Ti alloys and very high strengths required for structural components. Finally, mechanistic understanding of Si’s improvement of titanium oxidation resistance using Si-coated Ti specimens showed that Ti5Si3 silicide formation during oxidation exposures inhibited inward oxygen diffusion and formation of fast growing internal TiO2 scales. This understanding may inform not only the design of better protective coatings for alloys used at elevated temperatures but also the tailoring of alloy chemistries leading to similar oxidation mechanisms. In conclusion, the results detailed in this thesis address existing severe limitations associated with oxygen in titanium alloys. These findings directly impact commercial applications by providing design strategies to mitigate detrimental effects from interstitial oxygen, omega precipitation, and environmental degradation. This knowledge will contribute to future titanium alloy chemistry and processing development that utilizes beneficial impacts of elevated oxygen to enable new microstructures, properties, industrial material reuse, and commercial material specifications.PHDMaterials Science and EngineeringUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/168003/1/kachou_1.pd

Use of the Model Organism Caenorhabditis elegans to Elucidate Neurotoxic and Behavioral Effects of Commercial Fungicides

Fungicides are widely used in agriculture and medicine and there are several different types of fungicides that are distributed globally in the soil and water through water runoff and drift from spraying as well as other avenues of distribution. Understanding the biological effects of fungicide contaminants in the environment on non-target organisms including humans is critical. This chapter considers the use of the model organism and key beneficial soil nematode, Caenorhabditis elegans, as an effective strategy for examining fungicide effects on growth, reproduction, nervous system and behavior. We present novel evidence of the effects of a general use fungicide, mancozeb, on behavior and neuronal structure

Core competencies for pain management: results of an interprofessional consensus summit.

ObjectiveThe objective of this project was to develop core competencies in pain assessment and management for prelicensure health professional education. Such core pain competencies common to all prelicensure health professionals have not been previously reported.MethodsAn interprofessional executive committee led a consensus-building process to develop the core competencies. An in-depth literature review was conducted followed by engagement of an interprofessional Competency Advisory Committee to critique competencies through an iterative process. A 2-day summit was held so that consensus could be reached.ResultsThe consensus-derived competencies were categorized within four domains: multidimensional nature of pain, pain assessment and measurement, management of pain, and context of pain management. These domains address the fundamental concepts and complexity of pain; how pain is observed and assessed; collaborative approaches to treatment options; and application of competencies across the life span in the context of various settings, populations, and care team models. A set of values and guiding principles are embedded within each domain.ConclusionsThese competencies can serve as a foundation for developing, defining, and revising curricula and as a resource for the creation of learning activities across health professions designed to advance care that effectively responds to pain

Reefs at Risk: A Map-Based Indicator of Threats to the Worlds Coral Reefs

This report presents the first-ever detailed, map-based assessment of potential threats to coral reef ecosystems around the world. "Reefs at Risk" draws on 14 data sets (including maps of land cover, ports, settle-ments, and shipping lanes), information on 800 sites known to be degraded by people, and scientific expertise to model areas where reef degradation is predicted to occur, given existing human pressures on these areas. Results are an indicator of potential threat (risk), not a measure of actual condition. In some places, particularly where good management is practiced, reefs may be at risk but remain relatively healthy. In others, this indicator underestimates the degree to which reefs are threatened and degraded.Our results indicate that:Fifty-eight percent of the world's reefs are poten-tially threatened by human activity -- ranging from coastal development and destructive fishing practices to overexploitation of resources, marine pollution, and runoff from inland deforestation and farming.Coral reefs of Asia (Southeastern); the most species-rich on earth, are the most threatened of any region. More than 80 percent are at risk (undermedium and high potential threat), and over half are at high risk, primarily from coastal development and fishing-related pressures.Overexploitation and coastal development pose the greatest potential threat of the four risk categories considered in this study. Each, individually, affects a third of all reefs.The Pacific, which houses more reef area than any other region, is also the least threatened. About 60 percent of reefs here are at low risk.Outside of the Pacific, 70 percent of all reefs are at risk.At least 11 percent of the world's coral reefs contain high levels of reef fish biodiversity and are under high threat from human activities. These "hot spot" areas include almost all Philippine reefs, and coral communities off the coasts of Asia, the Comoros, and the Lesser Antilles in the Caribbean.Almost half a billion people -- 8 percent of the total global population -- live within 100 kilometers of a coral reef.Globally, more than 400 marine parks, sanctuaries, and reserves (marine protected areas) contain coral reefs. Most of these sites are very small -- more than 150 are under one square kilometer in size. At least 40 countries lack any marine protected areas for conserving their coral reef systems