Comparative embryology without a microscope: using genomic approaches to understand the evolution of development

Until recently, understanding developmental conservation and change has relied on embryological comparisons and analyses of single genes. Several studies, including one recently published in BMC Biology, have now taken a genomic approach to this classical problem, providing insights into how selection operates differentially across the life cycle

Lessons from Katrina – What Went Wrong, What Was Learned, Who’s Most Vulnerable

If humans did not occupy the planet, disasters would never occur. Massive climatic events, earthquakes, volcanic eruptions, and tsunamis would be regular occurrences, of course, and the earth would look like a dynamic cauldron of natural activity, changing the look and the balance of nature and natural events continuously and randomly. What morphs these natural phenomenon into catastrophic events we call “disasters” is simply the presence of human beings who by choice, chance, or necessity find themselves in harm’s way. The “human factors” may be straightforward and benign. For instance, people making their livelihood from the sea are at risk from coastal storms and tsunamis. Similarly, people are found living in areas at considerable risk for mudslides and volcanoes. It could even be said that living in New Orleans, a coastal city actually below sea level, is a gamble, as was so dramatically emphasized by the storms and subsequent flooding of August and September 2005

The Development of an Advanced Maintenance training programme utilizing Augmented Reality

Maintenance engineering represents an area of great opportunity to reduce cost, improve productivity, and increase profitability for manufacturing companies. There are examples of best practice that can be classed as World Class Maintenance which deliver great benefits. Unfortunately very few companies, and especially small and medium sized companies, remotely approach this level. Research has shown that savings of around 10% are achievable by improving asset management techniques through adopting modern maintenance practices, tools, and techniques. One area that is often overlooked is the development of an appropriate training programme in which the skills and knowledge are retained and used to develop the skills of young apprentices or new staff using specific technologies. Augmented Reality (AR) has been identified as a technology offering a promising approach to training which combines a number of disciplines including engineering, computing, and psychology. Augmented Reality (AR) enables users to view, through the use of see-through displays, virtual objects superimposed dynamically, and merged seamlessly, with real world objects in a real environment via a range of devices such as Ipad or Tablet, so that the virtual objects and real world images appear to exist at the same time in the same place providing real-time interaction. Therefore, this approach expands the surrounding real world environment by superimposing computer-generated information. It presents the information more intuitively than legacy interfaces such as paper-based instruction manuals enabling the users to interact directly with the information and use their natural spatial processing ability. This paper will identify augmented reality tools and techniques with the potential to support efficient training systems for maintenance and assembly skills that accelerate the technicians’ acquisition of new maintenance procedures. A platform for multimodal Augmented Reality based training will be proposed which could allow small to medium sized companies to develop and implement appropriate maintenance tasks based upon cost effective and efficient training systems. Such systems would give technicians’ the opportunity for practical training, that is, the possibility to “learn by doing” in the workplace; provide information when and where needed, thus reducing the technicians’ information search time; and potentially reduce errors due to violations in procedure, misinterpretation of facts, or insufficient training. A detailed bibliography on these topics is also provided

Why practice philosophy as a way of life?

This essay explains why there are good reasons to practice philosophy as a way of life. The argument begins with the assumption that we should live well but that our understanding of how to live well can be mistaken. Philosophical reason and reflection can help correct these mistakes. Nonetheless, the evidence suggests that philosophical reasoning often fails to change our dispositions and behavior. Drawing on the work of Pierre Hadot, the essay claims that spiritual exercises and communal engagement mitigate the factors that prevent us from living in accord- ance with our conceptions of the good life. So, many of us have reasons to engage in philosophical reasoning along with behavioral, cognitive, and social strategies to alter our behavior and attitudes so that they’re in line with our philosophical commitments. In these respects, many of us should practice philosophy as a way of life

Prevalence and Predictors of Mental Health Distress Post-Katrina: Findings From the Gulf Coast Child and Family Health Study

Background: Catastrophic disasters often are associated with massive structural, economic, and population devastation; less understood are the long-term mental health consequences. This study measures the prevalence and predictors of mental health distress and disability of hurricane survivors over an extended period of recovery in a postdisaster setting. Methods: A representative sample of 1077 displaced or greatly affected households was drawn in 2006 using a stratified cluster sampling of federally subsidized emergency housing settings in Louisiana and Mississippi, and of Mississippi census tracts designated as having experienced major damage from Hurricane Katrina in 2005. Two rounds of data collection were conducted: a baseline face-to-face interview at 6 to 12 months post-Katrina, and a telephone follow-up at 20 to 23 months after the disaster. Mental health disability was measured using the Medical Outcome Study Short Form 12, version 2 mental component summary score. Bivariate and multivariate analyses were conducted examining socioeconomic, demographic, situational, and attitudinal factors associated with mental health distress and disability. Results: More than half of the cohort at both baseline and follow-up reported significant mental health distress. Self-reported poor health and safety concerns were persistently associated with poorer mental health. Nearly 2 years after the disaster, the greatest predictors of poor mental health included situational characteristics such as greater numbers of children in a household and attitudinal characteristics such as fatalistic sentiments and poor self-efficacy. Informal social support networks were associated significantly with better mental health status. Housing and economic circumstances were not independently associated with poorer mental health. Conclusions: Mental health distress and disability are pervasive issues among the US Gulf Coast adults and children who experienced long-term displacement or other serious effects as a result of Hurricanes Katrina and Rita. As time progresses postdisaster, social and psychological factors may play greater roles in accelerating or impeding recovery among affected populations. Efforts to expand disaster recovery and preparedness policies to include long-term social re-engagement efforts postdisaster should be considered as a means of reducing mental health sequelae

Prevalence and Predictors of Mental Health Distress Post-Katrina: Findings From the Gulf Coast Child and Family Health Study

Background: Catastrophic disasters often are associated with massive structural, economic, and population devastation; less understood are the long-term mental health consequences. This study measures the prevalence and predictors of mental health distress and disability of hurricane survivors over an extended period of recovery in a postdisaster setting. Methods: A representative sample of 1077 displaced or greatly affected households was drawn in 2006 using a stratified cluster sampling of federally subsidized emergency housing settings in Louisiana and Mississippi, and of Mississippi census tracts designated as having experienced major damage from Hurricane Katrina in 2005. Two rounds of data collection were conducted: a baseline face-to-face interview at 6 to 12 months post-Katrina, and a telephone follow-up at 20 to 23 months after the disaster. Mental health disability was measured using the Medical Outcome Study Short Form 12, version 2 mental component summary score. Bivariate and multivariate analyses were conducted examining socioeconomic, demographic, situational, and attitudinal factors associated with mental health distress and disability. Results: More than half of the cohort at both baseline and follow-up reported significant mental health distress. Self-reported poor health and safety concerns were persistently associated with poorer mental health. Nearly 2 years after the disaster, the greatest predictors of poor mental health included situational characteristics such as greater numbers of children in a household and attitudinal characteristics such as fatalistic sentiments and poor self-efficacy. Informal social support networks were associated significantly with better mental health status. Housing and economic circumstances were not independently associated with poorer mental health. Conclusions: Mental health distress and disability are pervasive issues among the US Gulf Coast adults and children who experienced long-term displacement or other serious effects as a result of Hurricanes Katrina and Rita. As time progresses postdisaster, social and psychological factors may play greater roles in accelerating or impeding recovery among affected populations. Efforts to expand disaster recovery and preparedness policies to include long-term social re-engagement efforts postdisaster should be considered as a means of reducing mental health sequelae

Predicting preschool pain-related anticipatory distress: the relative contribution of longitudinal and concurrent factors

Anticipatory distress prior to a painful medical procedure can lead to negative sequelae including heightened pain experiences, avoidance of future medical procedures, and potential non-compliance with preventative healthcare such as vaccinations. Few studies have examined the longitudinal and concurrent predictors of pain-related anticipatory distress. This paper consists of two companion studies to examine both the longitudinal factors from infancy, as well as concurrent factors from preschool that predict pain-related anticipatory distress at the preschool age. Study 1 examined how well preschool pain-related anticipatory distress was predicted by infant pain responding at 2, 4, 6 and 12 months of age. In Study 2, using a developmental psychopathology framework, longitudinal analyses examined the predisposing, precipitating, perpetuating, and present factors that led to the development of anticipatory distress during routine preschool vaccinations. A sample of 202 caregiverchild dyads was observed during their infant and preschool vaccinations (OUCH Cohort) and was used for both studies. In Study 1, pain responding during infancy was not found to significantly predict pain-related anticipatory distress at preschool. In Study 2, a strong explanatory model was created whereby 40% of the variance in preschool anticipatory distress was explained. Parental behaviours from infancy and preschool were the strongest predictors of child anticipatory distress at preschool. Child age positively predicted child anticipatory distress. This strongly suggests that the involvement of parents in pain management interventions during immunization is one of the most critical factors in predicting anticipatory distress to the preschool vaccination

Long-term effectiveness and cost-effectiveness of cognitive behavioural therapy as an adjunct to pharmacotherapy for treatment-resistant depression in primary care: follow-up of the CoBalT randomised controlled trial

Background: Cognitive behavioural therapy (CBT) is an effective treatment for people whose depression has not responded to antidepressants. However, the long-term outcome is unknown. In a long-term follow-up of the CoBalT trial, we examined the clinical and cost-effectiveness of cognitive behavioural therapy as an adjunct to usual care that included medication over 3–5 years in primary care patients with treatment-resistant depression. Methods: CoBalT was a randomised controlled trial done across 73 general practices in three UK centres. CoBalT recruited patients aged 18–75 years who had adhered to antidepressants for at least 6 weeks and had substantial depressive symptoms (Beck Depression Inventory [BDI-II] score ≥14 and met ICD-10 depression criteria). Participants were randomly assigned using a computer generated code, to receive either usual care or CBT in addition to usual care. Patients eligible for the long-term follow-up were those who had not withdrawn by the 12 month follow-up and had given their consent to being re-contacted. Those willing to participate were asked to return the postal questionnaire to the research team. One postal reminder was sent and non-responders were contacted by telephone to complete a brief questionnaire. Data were also collected from general practitioner notes. Follow-up took place at a variable interval after randomisation (3–5 years). The primary outcome was self-report of depressive symptoms assessed by BDI-II score (range 0–63), analysed by intention to treat. Cost-utility analysis compared health and social care costs with quality-adjusted life-years (QALYs). This study is registered with isrctn.com, number ISRCTN38231611. Findings: Between Nov 4, 2008, and Sept 30, 2010, 469 eligible participants were randomised into the CoBalT study. Of these, 248 individuals completed a long-term follow-up questionnaire and provided data for the primary outcome (136 in the intervention group vs 112 in the usual care group). At follow-up (median 45·5 months [IQR 42·5–51·1]), the intervention group had a mean BDI-II score of 19·2 (SD 13·8) compared with a mean BDI-II score of 23·4 (SD 13·2) for the usual care group (repeated measures analysis over the 46 months: difference in means −4·7 [95% CI −6·4 to −3·0, p<0·001]). Follow-up was, on average, 40 months after therapy ended. The average annual cost of trial CBT per participant was £343 (SD 129). The incremental cost-effectiveness ratio was £5374 per QALY gain. This represented a 92% probability of being cost effective at the National Institute for Health and Care Excellence QALY threshold of £20 000. Interpretation: CBT as an adjunct to usual care that includes antidepressants is clinically effective and cost effective over the long-term for individuals whose depression has not responded to pharmacotherapy. In view of this robust evidence of long-term effectiveness and the fact that the intervention represented good value-for-money, clinicians should discuss referral for CBT with all those for whom antidepressants are not effective

On the Edge: Children and Families Displaced by Hurricanes Katrina and Rita Face a Looming Medical and Mental Health Crisis

The individuals and families who were displaced by Hurricanes Katrina and Rita and who have ended up in FEMA-subsidized community housing in Louisiana are facing a second crisis, one in which untreated and undertreated chronic medical problems and incipient mental health issues will overwhelm patients and providers. Among the displaced, children may be particularly vulnerable. In New Orleans alone, approximately 110,000 children under age eighteen — 85% of the pre-Katrina pediatric population — have not returned to the city since the hurricanes. These children, and others from outside of New Orleans, have been scattered throughout the Gulf Coast and across the fifty states. Louisiana's school enrollment dropped by 70,000 students, many of whom have resettled in other states, some who have not yet returned to school in Louisiana. The Louisiana Child & Family Health Study focused on the displaced population living in FEMA-subsidized housing in Louisiana, and who may be among the most needy. According to interviews with adults in 665 randomly selected households at trailer communities and hotels throughout the state, this displaced group of children and families suffers from a constellation of serious medical and mental health problems. Parents report high rates of asthma, behavioral problems, and learning disabilities among their children. Despite that, access to continuous medical care, appropriate mental health care, medications, specialized medical equipment, and specialty medical care, is either fragmented at best, or absent altogether. The medical and mental health needs documented in this report may be regarded as the consequence of inadequately treated chronic diseases, psychological and emotional traumas secondary to the chaos and despair of a massive dislocation, and the social deprivations of the chronically-poor and the newly-impoverished. At a deeper level, though, the problems relate to the loss of stability in people's lives: families that are increasingly fragile, children who are disengaged from schools, and the wholesale loss of community, workplace, and health care providers and institutions

On the Edge: Children and Families Displaced by Hurricanes Katrina andRita Face a Looming Medical and Mental Health Crisis: Executive Summary

The individuals and families who were displaced by Hurricanes Katrina and Rita and who have ended up in FEMA-subsidized community housing in Louisiana are facing a second crisis, one in which untreated and undertreated chronic medical problems and incipient mental health issues will overwhelm patients and providers. Among the displaced, children may be particularly vulnerable. In New Orleans alone, approximately 110,000 children under age eighteen — 85% of the pre-Katrina pediatric population — have not returned to the city since the hurricanes. These children, and others from outside of New Orleans, have been scattered throughout the Gulf Coast and across the fifty states. Louisiana's school enrollment dropped by 70,000 students, many of whom have resettled in other states, some who have not yet returned to school in Louisiana. The Louisiana Child & Family Health Study focused on the displaced population living in FEMA-subsidized housing in Louisiana, and who may be among the most needy. According to interviews with adults in 665 randomly selected households at trailer communities and hotels throughout the state, this displaced group of children and families suffers from a constellation of serious medical and mental health problems. Parents report high rates of asthma, behavioral problems, and learning disabilities among their children. Despite that, access to continuous medical care, appropriate mental health care, medications, specialized medical equipment, and specialty medical care, is either fragmented at best, or absent altogether. The medical and mental health needs documented in this report may be regarded as the consequence of inadequately treated chronic diseases, psychological and emotional traumas secondary to the chaos and despair of a massive dislocation, and the social deprivations of the chronically-poor and the newly-impoverished. At a deeper level, though, the problems relate to the loss of stability in people's lives: families that are increasingly fragile, children who are disengaged from schools, and the wholesale loss of community, workplace, and health care providers and institutions