Flood- and Weather-Damaged Homes and Mental Health: An Analysis Using England's Mental Health Survey

There is increasing evidence that exposure to weather-related hazards like storms and floods adversely affects mental health. However, evidence of treated and untreated mental disorders based on diagnostic criteria for the general population is limited. We analysed the Adult Psychiatric Morbidity Survey, a large probability sample survey of adults in England (n = 7525), that provides the only national data on the prevalence of mental disorders assessed to diagnostic criteria. The most recent survey (2014–2015) asked participants if they had experienced damage to their home (due to wind, rain, snow or flood) in the six months prior to interview, a period that included months of unprecedented population exposure to flooding, particularly in Southern England. One in twenty (4.5%) reported living in a storm- or flood-damaged home in the previous six months. Social advantage (home ownership, higher household income) increased the odds of exposure to storm or flood damage. Exposure predicted having a common mental disorder over and above the effects of other known predictors of poor mental health. With climate change increasing the frequency and severity of storms and flooding, improving community resilience and disaster preparedness is a priority. Evidence on the mental health of exposed populations is key to building this capacity

Learning Development and Education for Sustainability: what are the links?

Learning Development (LD) is an emerging discipline developing a unique disciplinary identity. In common with many other new fields, it considers its position and relevance to other disciplines and bodies of thought, and in particular, educational development, applied linguistics and the sociology and philosophy of education. This paper considers one such area of debate: the link between Learning Development and Education for Sustainability (EfS). EfS is an area of pedagogic practice and a field of enquiry of considerable and growing importance in Higher Education (HE) and universities. Its underpinning systemic and epistemic philosophies suggest the need for integration across all facets of university activity, including LD. In this paper, we argue that there are identifiable links between LD and EfS that extend these philosophies, practices and fields of enquiry, characterised by the following: 1) commonalities surrounding the foci of their pedagogic practices, 2) shared methodologies for undertaking their practices, and 3) ways in which these methodologies are helping to situate both professions and disciplines within organisational contexts. The commonalities and possible distinctions between LD and EfS form a starting point for discussion, and raise the possibility that explicit identification of the links may encourage increased collaboration between the respective communities of practice, and the development of new ideas and innovative practice

Direct and indirect costs of paediatric asthma in the UK : a cost analysis

We thank all the children who took part in the study and their families, and the staff at recruitment sites who facilitated identification, recruitment and follow-up of study participants. We acknowledge Jessica Wood, Victoria Bell and Andrea Fraser from the RAACENO trial office. We also thank Aileen Neilson who initially led the health economic aspects of the RAACENO trial.Peer reviewe

Does the discussion help? The impact of a formally assessed online discussion on final student results

While there is agreement that participation in online asynchronous discussions can enhance student learning, it has also been identified that there is a need to investigate the impact of participation in online discussions on student course performance. This paper presents a case study based on an undergraduate engineering management unit employing a formally assessed online discussion area. It was observed that while many students read a significant number of discussion postings, generally, the posting of new and reply messages occurred at the minimum level required to qualify for the assignment marks. Based on correlation and multiple regression analysis, it was observed that two variables were significantly related to a student\u27s final unit mark&mdash;prior academic ability and the number of new postings made to the online discussion. Each new posting contributed three times as much to the final unit mark as its nominal assessment value, suggesting that the work in preparing their new discussion postings assisted students in the completion of a range of assessable tasks for the unit. The number of postings read was not significantly correlated with the final unit mark, suggesting that passive lurking in this online discussion did not significantly contribute to student learning outcomes.<br /

Are Drivers of Root-Associated Fungal Community Structure Context Specific?

The composition and structure of plant-root-associated fungal communities are determined by local abiotic and biotic conditions. However, the relative influence and identity of relationships to abiotic and biotic factors may differ across environmental and ecological contexts, and fungal functional groups. Thus, understanding which aspects of root-associated fungal community ecology generalise across contexts is the first step towards a more predictive framework. We investigated how the relative importance of biotic and abiotic factors scale across environmental and ecological contexts using high-throughput sequencing (ca. 55 M Illumina metabarcoding sequences) of >260 plant-root-associated fungal communities from six UK salt marshes across two geographic regions (South-East and North-West England) in winter and summer. Levels of root-associated fungal diversity were comparable with forests and temperate grasslands, quadrupling previous estimates of salt-marsh fungal diversity. Whilst abiotic variables were generally most important, a range of site- and spatial scale-specific abiotic and biotic drivers of diversity and community composition were observed. Consequently, predictive models of diversity trained on one site, extrapolated poorly to others. Fungal taxa from the same functional groups responded similarly to the specific drivers of diversity and composition. Thus site, spatial scale and functional group are key factors that, if accounted for, may lead to a more predictive understanding of fungal community ecology

Variational Principles for Natural Divergence-free Tensors in Metric Field Theories

Let $T^{ab}=T^{ba}=0$ be a system of differential equations for the components of a metric tensor on $R^m$. Suppose that $T^{ab}$ transforms tensorially under the action of the diffeomorphism group on metrics and that the covariant divergence of $T^{ab}$ vanishes. We then prove that $T^{ab}$ is the Euler-Lagrange expression some Lagrangian density provided that $T^{ab}$ is of third order. Our result extends the classical works of Cartan, Weyl, Vermeil, Lovelock, and Takens on identifying field equations for the metric tensor with the symmetries and conservation laws of the Einstein equations

An investigation of factors associated with psychiatric hospital admission despite the presence of crisis resolution teams.

RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.BACKGROUND: Crisis resolution teams (CRTs) provide a community alternative to psychiatric hospital admission for patients presenting in crisis. Little is known about the characteristics of patients admitted despite the availability of such teams. METHODS: Data were drawn from three investigations of the outcomes of CRTs in inner London. A literature review was used to identify candidate explanatory variables that may be associated with admission despite the availability of intensive home treatment. The main outcome variable was admission to hospital within 8 weeks of the initial crisis. Associations between this outcome and the candidate explanatory variables were tested using first univariate and then multivariate analysis. RESULTS: Patients who were uncooperative with initial assessment (OR 10.25 95% CI-4.20-24.97), at risk of self-neglect (OR 2.93 1.42-6.05), had a history of compulsory admission (OR 2.64 1.07-6.55), assessed outside usual office hours (OR 2.34 1.11-4.94) and/or were assessed in hospital casualty departments (OR 3.12 1.55-6.26), were more likely to be admitted. Other than age, no socio-demographic features or diagnostic variables were significantly associated with risk of admission. CONCLUSION: With the introduction of CRTs, inpatient wards face a significant challenge, as patients who cooperate little with treatment, neglect themselves, or have previously been compulsorily detained are especially likely to be admitted. The increased risk of admission associated with casualty department assessment may be remediable

Beyond opposition and acceptance: examining public perceptions of the environmental and health impacts of unconventional oil and gas extraction

This review of public perceptions of unconventional oil and gas exploration identifies four main types of study. First, UOG is analysed in terms of specific environmental and public health impacts. Second, by examining socioeconomic impacts (namely the development of energy boom-towns). Third, in terms of the relationship between prior knowledge of UOG technology and public attitudes of support or opposition. Fourth, in terms of framing and discursive analysis of UOG by stakeholder groups including the print media. We identify a specific knowledge gap for environmental health professionals: that research is needed into how public and environmental health messages can be best communicated to diverse communities potentially affected by fracking, in order to directly improve public health outcomes

Effect of Theophylline as Adjunct to Inhaled Corticosteroids on Exacerbations in Patients With COPD: A Randomized Clinical Trial

Importance: Chronic obstructive pulmonary disease (COPD) is a major global health issue and theophylline is used extensively. Preclinical investigations have demonstrated that low plasma concentrations (1-5 mg/L) of theophylline enhance antiinflammatory effects of corticosteroids in COPD.  Objective: To investigate the effectiveness of adding low-dose theophylline to inhaled corticosteroids in COPD.  Design, Setting, and Participants: The TWICS (theophylline with inhaled corticosteroids) trial was a pragmatic, double-blind, placebo-controlled, randomized clinical trial that enrolled patients with COPD between February 6, 2014, and August 31, 2016. Final follow-up ended on August 31, 2017. Participants had a ratio of forced expiratory volume in the first second to forced vital capacity (FEV1/FVC) of less than 0.7 with at least 2 exacerbations (treated with antibiotics, oral corticosteroids, or both) in the previous year and were using an inhaled corticosteroid. This study included 1578 participants in 121 UK primary and secondary care sites.  Interventions: Participants were randomized to receive low-dose theophylline (200 mg once or twice per day) to provide plasma concentrations of 1 to 5 mg/L (determined by ideal body weight and smoking status) (n = 791) or placebo (n = 787).  Main Outcomes and Measures: The number of participant-reported moderate or severe exacerbations treated with antibiotics, oral corticosteroids, or both over the 1-year treatment period.  Results: Of the 1567 participants analyzed, mean (SD) age was 68.4 (8.4) years and 54% (843) were men. Data for evaluation of the primary outcome were available for 1536 participants (98%) (772 in the theophylline group; 764 in the placebo group). In total, there were 3430 exacerbations: 1727 in the theophylline group (mean, 2.24 [95% CI, 2.10-2.38] exacerbations per year) vs 1703 in the placebo group (mean, 2.23 [95% CI, 2.09-2.37] exacerbations per year); unadjusted mean difference, 0.01 (95% CI, −0.19 to 0.21) and adjusted incidence rate ratio, 0.99 (95% CI, 0.91-1.08). Serious adverse events in the theophylline and placebo groups included cardiac, 2.4% vs 3.4%; gastrointestinal, 2.7% vs 1.3%; and adverse reactions such as nausea (10.9% vs 7.9%) and headaches (9.0% vs 7.9%).  Conclusions and Relevance: Among adults with COPD at high risk of exacerbation treated with inhaled corticosteroids, the addition of low-dose theophylline, compared with placebo, did not reduce the number COPD exacerbations over a 1-year period. The findings do not support the use of low-dose theophylline as adjunctive therapy to inhaled corticosteroids for the prevention of COPD exacerbations