Excess years of life lost to COVID-19 and other causes of death by sex, neighbourhood deprivation, and region in England and Wales during 2020: A registry-based study

BackgroundDeaths in the first year of the Coronavirus Disease 2019 (COVID-19) pandemic in England and Wales were unevenly distributed socioeconomically and geographically. However, the full scale of inequalities may have been underestimated to date, as most measures of excess mortality do not adequately account for varying age profiles of deaths between social groups. We measured years of life lost (YLL) attributable to the pandemic, directly or indirectly, comparing mortality across geographic and socioeconomic groups.Methods and findingsWe used national mortality registers in England and Wales, from 27 December 2014 until 25 December 2020, covering 3,265,937 deaths. YLLs (main outcome) were calculated using 2019 single year sex-specific life tables for England and Wales. Interrupted time-series analyses, with panel time-series models, were used to estimate expected YLL by sex, geographical region, and deprivation quintile between 7 March 2020 and 25 December 2020 by cause: direct deaths (COVID-19 and other respiratory diseases), cardiovascular disease and diabetes, cancer, and other indirect deaths (all other causes). Excess YLL during the pandemic period were calculated by subtracting observed from expected values. Additional analyses focused on excess deaths for region and deprivation strata, by age-group. Between 7 March 2020 and 25 December 2020, there were an estimated 763,550 (95% CI: 696,826 to 830,273) excess YLL in England and Wales, equivalent to a 15% (95% CI: 14 to 16) increase in YLL compared to the equivalent time period in 2019. There was a strong deprivation gradient in all-cause excess YLL, with rates per 100,000 population ranging from 916 (95% CI: 820 to 1,012) for the least deprived quintile to 1,645 (95% CI: 1,472 to 1,819) for the most deprived. The differences in excess YLL between deprivation quintiles were greatest in younger age groups; for all-cause deaths, a mean of 9.1 years per death (95% CI: 8.2 to 10.0) were lost in the least deprived quintile, compared to 10.8 (95% CI: 10.0 to 11.6) in the most deprived; for COVID-19 and other respiratory deaths, a mean of 8.9 years per death (95% CI: 8.7 to 9.1) were lost in the least deprived quintile, compared to 11.2 (95% CI: 11.0 to 11.5) in the most deprived. For all-cause mortality, estimated deaths in the most deprived compared to the most affluent areas were much higher in younger age groups, but similar for those aged 85 or over. There was marked variability in both all-cause and direct excess YLL by region, with the highest rates in the North West. Limitations include the quasi-experimental nature of the research design and the requirement for accurate and timely recording.ConclusionsIn this study, we observed strong socioeconomic and geographical health inequalities in YLL, during the first calendar year of the COVID-19 pandemic. These were in line with long-standing existing inequalities in England and Wales, with the most deprived areas reporting the largest numbers in potential YLL

Hot nanoindentation in inert environments

An instrument capable of performing nanoindentation at temperatures up to 500 °C in inert atmospheres, including partial vacuum and gas near atmospheric pressures, is described. Technical issues associated with the technique (such as drift and noise) and the instrument (such as tip erosion and radiative heating of the transducer) are identified and addressed. Based on these considerations, preferred operation conditions are identified for testing on various materials. As a proof-of-concept demonstration, the hardness and elastic modulus of three materials are measured: fused silica (nonoxidizing), aluminum, and copper (both oxidizing). In all cases, the properties match reasonably well with published data acquired by more conventional test methods.United States. Office of Naval Research (Contract No. N00014-08-1-0312)Massachusetts Institute of Technology. Institute for Soldier Nanotechnologie

Copper complexes as a source of redox active MRI contrast agents

The study reports an advance in designing copper-based redox sensing MRI contrast agents. Although the data demonstrate that copper(II) complexes are not able to compete with lanthanoids species in terms of contrast, the redox-dependent switch between diamagnetic copper(I) and paramagnetic copper(II) yields a novel redox-sensitive contrast moiety with potential for reversibility

The Impact of Shame, Self-Criticism and Social Rank on Eating Behaviours in Overweight and Obese Women Participating in a Weight Management Programme

Recent research has suggested that obesity is a stigmatised condition. Concerns with personal inferiority (social rank), shame and self-criticism may impact on weight management behaviours. The current study examined associations between social comparison (shame, self-criticism), negative affect and eating behaviours in women attending a community based weight management programme focused on behaviour change. 2,236 participants of the programme completed an online survey using measures of shame, self-criticism, social comparison, and weight-related affect, which were adapted to specifically address eating behaviour, weight and body shape perceptions. Correlation analyses showed that shame, self-criticism and social comparison were associated with negative affect. All of these variables were related to eating regulation and weight control (p < 0.001). Path analysis revealed that the association of shame, hated-self, and low self-reassurance on disinhibition and susceptibility to hunger was fully mediated by weight-related negative affect, even when controlling for the effect of depressive symptoms (p < 0.050 to p < 0.010). In addition, feelings of inadequacy and unfavourable social comparisons were associated with higher disinhibition and susceptibility to hunger, partially mediated through weight-related negative affect (p = 0.001). These variables were negatively associated with extent of weight loss during programme attendance prior to the survey, while self-reassurance and positive social comparisons were positively associated with the extent of weight loss prior to the survey (p < .050). Shame, self-criticism, and perceptions of inferiority may play a significant role in self-regulation of eating behaviour in overweight people trying to manage their weight

An exploration of compassion and eating disorders : a mixed methods approach

Compassion Focused Therapy (CFT) was specifically developed for people with high levels of shame and self-criticism, who have difficulties with self-reassurance and self-compassion. It draws on evolutionary theories, particularly attachment theory, and neuroscience research of affect regulation. CFT has promising results with people with depression, psychosis and chronic mental health difficulties. However, the use of CFT has not been explored with people with eating disorders, who tend to be very self-critical and prone to experiencing shame. Therefore the aim of this research was to explore compassion in relation to eating disorders. To facilitate this, three related studies were undertaken. The aims of these studies were to: 1) Evaluate the outcomes of introducing CFT into a standard treatment programme for people with eating disorders in order to establish whether CFT can be used with this group of individuals. 2) Investigate the outcomes of a stand-alone Compassionate Mind Training (CMT) programme within a self-help setting and to explore participants' experiences of the programme. 3) Explore experiences of compassion from others in childhood, and current self- compassion, of people with eating difficulties. A mixed methodology approach was adopted, with repeated questionnaire measures used to investigate the outcomes of the interventions, and qualitative methods (specifically Interpretative Phenomenological Analysis) to explore the experiences of the CMT programme and experiences of childhood and current compassion. The results of Study 1 confirmed that CFT can be integrated into a standard treatment programme for people with eating disorders, with significant improvements in the cognitive and behavioural symptoms and psychopathological aspects of eating disorders, and more general psychological distress. This approach was particularly beneficial for people with bulimia nervosa or atypical eating disorders. Study 2 demonstrated that a CMT programme, which introduced the evolutionary model underpinning CFT and the specific training exercises included within the therapy, led to improvements on a range of questionnaire measures assessing eating difficulties, well-being, shame and self-criticism. Even though the programme did not focus specifically on eating difficulties, weight and shape concern both significantly reduced. This suggests that helping people to be more self-compassionate can impact on eating psychopathology. The qualitative data showed that the participants found the programme acceptable and benefitted from learning about the evolution of the brain and affect regulation systems. They also describe benefitting from the exercises and working as a group, which helped to develop a sense of safeness and allowed them to share their experiences. Study 3 identified six main themes, three relating to childhood experiences of compassion and three to current self-compassion. Participants recalled having difficulties in dealing with emotions from a very early age. In particular, they described how there was an interaction between their own temperament (e.g. concealment or withdrawal) and allowing their parents to be more emotionally engaged with them. Participants also experienced difficulties with current self- compassion, instead they tended to experience self-criticism and shame, and often used food to soothe themselves, either by restricting their eating or binge eating. To conclude, the research presented in this thesis provides the first evidence to support the use of GFT and GMT with people with eating disorders. It is also the first to explore experiences of the GMT programme and of people's early experiences of compassion and current self-compassion.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Potential Effects of Fat-Controlled, Low-Cholesterol Diet on U.S. Food Consumption

If the entire U.S. population were to select one food pattern among those that meet the American Heart Association recommendations for a fat-controlled, low-cholesterol diet, calorie intake would decline about 13 percent compared with present consumption. The cost would be about a tenth higher, however, since beef, poultry, fish, and fruits and vegetables would partly replace lower priced foods such as pork, eggs, fats, and sugars. The farm value of the foods would be about the same as for current food consumption patterns. The total amount of agricultural resources required would change little but there would be shifts within the farm sector

‘Do you practice what you preach?’ A qualitative exploration of therapists' personal practice of compassion focused therapy.

Background Therapists' personal practice of therapy techniques can impact on a range of areas, including: empathy for the client, therapeutic understanding, therapist skills and self-awareness. Compassion Focused Therapy (CFT) draws extensively on personal practice during training, and on-going personal practice is encouraged. However, the impact of this has not been examined.Background Therapists' personal practice of therapy techniques can impact on a range of areas, including: empathy for the client, therapeutic understanding, therapist skills and self-awareness. Compassion Focused Therapy (CFT) draws extensively on personal practice during training, and on-going personal practice is encouraged. However, the impact of this has not been examined

The dark side of competition: How competitive behaviour and striving to avoid inferiority are linked to depression, anxiety, stress and self-harm

This study was guided by the social rank theory of depression and aimed to explore the relationship between depression, anxiety, stress and self‐harm with striving to avoid inferiority, feelings of shame and styles of attachment. Participants diagnosed with depression (n=62) completed a series of questionnaires measuring striving to avoid inferiority, fears of missing out, being overlooked and active rejection, attachment, social rank and psychopathologies. Striving to avoid inferiority was significantly linked to social rank variables and anxious attachment. Mediator analyses revealed that the relationship between striving to avoid inferiority and depression was mediated by the social rank variable of external shame, and also anxious attachment. These findings suggest that elevated competitive behaviour can have a ‘dark side’. When people feel insecure in their social environments, it can focus them on a hierarchical view of themselves and others, with a fear of rejection if they feel they have become too inferior or subordinate. This may increase vulnerability to depression, anxiety and stress.N/

Practical compassions: repertoires of practice and compassion talk in acute mental healthcare

This article reports an exploratory study of the concept of compassion in the work of 20 mental health practitioners in a UK Midlands facility. Using notions of practice derived from phenomenology and Bourdieusian sociology and notions of emotional labour we identify two contrasting interpretive repertoires in discussions of compassion. The first, the practical compassion repertoire, evokes the practical, physical and bodily aspects of compassion. It involves organising being with patients, playing games, anticipating disruption and taking them outside for cigarettes. Practitioners described being aware that these practical, bodily activities could lead to patients ‘opening up’, disclosing their interior concerns and enabling practical, compassionate mental health work to take place. In contrast, the second, organisational repertoire, concerns organisational constraints on compassionate practice. The shortage of staff, the record-keeping and internal processes of quality control were seen as time-greedy and apt to detract from contact with patients. The findings are discussed in relation to Bourdieu and Merleau-Ponty's phenomenological accounts of practice and habit and set in context in the growing interest in placing compassion centrally in healthcare. We also explore how the exercise of compassion in the way our participants describe it can afford the more effective exercise of medical power