Syndemic contexts: findings from a review of research on non-communicable diseases and interviews with experts

Background Syndemics are characterized by the clustering of two or more health conditions, their adverse interaction, and contextual factors that create the conditions for clustering and/or interaction that worsens health outcomes. Studying syndemics entails drawing on diverse disciplines, including epidemiology and anthropology. This often means collaboration between researchers with different scholarly backgrounds, who share and – ideally – integrate their findings. Objective This article examines how context within syndemics has been defined and studied. Methods A literature review of empirical studies focusing on syndemics involving non-communicable diseases (NCDs) and mental health conditions was conducted and the full text of 13 articles was analyzed. The review was followed-up with semi-structured interviews with 11 expert researchers working in the field. Results The review and interviews highlighted a relatively consistent definition of syndemics. The reviewed studies of NCD-related syndemics tended to focus on micro-level context, suggesting a need to analyze further underlying structural factors. In their syndemics research, respondents described working with other disciplines and, although there were some challenges, welcomed greater disciplinary diversity. Methodological gaps, including a lack of mixed methods and longitudinal studies, were identified, for which further interdisciplinary collaborations would be beneficial. Conclusions NCD-related syndemics research would benefit from further analysis of structural factors and the interconnections between syndemic components across multiple levels, together with more ambitious research designs integrating quantitative and qualitative methods. Research on the COVID-19 pandemic can benefit from a syndemics approach, particularly to understand vulnerability and the unequal impacts of this public health crisis

Observation of Andreev Reflection Enhanced Shot Noise

We have experimentally investigated the quasiparticle shot noise in NbN/MgO/NbN superconductor - insulator - superconductor tunnel junctions. The observed shot noise is significantly larger than theoretically expected. We attribute this to the occurrence of multiple Andreev reflection processes in pinholes present in the MgO barrier. This mechanism causes the current to flow in large charge quanta (Andreev clusters), with a voltage dependent average value of m = 1+ 2 Delta/eV times the electron charge. Because of this charge enhancement effect, the shot noise is increased by the factor m.Comment: 4 pages, 5 figures include

Crop growth models for the -omics era: the EU-SPICY project

The prediction of phenotypic responses from genetic and environmental information is an area of active research in genetics, physiology and statistics. Rapidly increasing amounts of phenotypic information become available as a consequence of high throughput phenotyping techniques, while more and cheaper genotypic data follow from the development of new genotyping platforms. , A wide array of -omics data can be generated linking genotype and phenotype. Continuous monitoring of environmental conditions has become an accessible option. This wealth of data requires a drastic rethinking of the traditional quantitative genetic approach to modeling phenotypic variation in terms of genetic and environmental differences. Where in the past a single phenotypic trait was partitioned in a genetic and environmental component by analysis of variance techniques, nowadays we desire to model multiple, interrelated and often time dependent, phenotypic traits as a function of genes (QTLs) and environmental inputs, while we would like to include transcription information as well. The EU project 'Smart tools for Prediction and Improvement of Crop Yield' (KBBE-2008-211347), or SPICY, aims at the development of genotype-to-phenotype models that fully integrate genetic, genomic, physiological and environmental information to achieve accurate phenotypic predictions across a wide variety of genetic and environmental configurations. Pepper (Capsicum annuum) is chosen as the model crop, because of the availability of genetically characterized populations and of generic models for continuous crop growth and greenhouse production. In the presentation the objectives and structure of SPICY as well as its philosophy will be discussed

Resistively-shunted superconducting quantum point contacts

We have studied the Josephson dynamics of resistively-shunted ballistic superconducting quantum point contacts at finite temperatures and arbitrary number of conducting modes. Compared to the classical Josephson dynamics of tunnel junctions, dynamics of quantum point contacts exhibits several new features associated with temporal fluctuations of the Josephson potential caused by fluctuations in the occupation of the current-carrying Andreev levels.Comment: 5 pages, RevTex, 3 postscript figures include

Protocol for the development and validation procedure of the managing the link and strengthening transition from child to adult mental health care (MILESTONE) suite of measures

Background: Mental health disorders in the child and adolescent population are a pressing public health concern. Despite the high prevalence of psychopathology in this vulnerable population, the transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) has many obstacles such as deficiencies in planning, organisational readiness and policy gaps. All these factors contribute to an inadequate and suboptimal transition process. A suite of measures is required that would allow young people to be assessed in a structured and standardised way to determine the on-going need for care and to improve communication across clinicians at CAMHS and AMHS. This will have the potential to reduce the overall health economic burden and could also improve the quality of life for patients travelling across the transition boundary. The MILESTONE (Managing the Link and Strengthening Transition from Child to Adult Mental Health Care) project aims to address the significant socioeconomic and societal challenge related to the transition process. This protocol paper describes the development of two MILESTONE transition-related measures: The Transition Readiness and Appropriateness Measure (TRAM), designed to be a decision-making aide for clinicians, and the Transition Related Outcome Measure (TROM), for examining the outcome of transition. Methods: The TRAM and TROM have been developed and were validated following the US FDA Guidance for Patient-reported Outcome Measures which follows an incremental stepwise framework. The study gathers information from service users, parents, families and mental health care professionals who have experience working with young people undergoing the transition process from eight European countries. Discussion: There is an urgent need for comprehensive measures that can assess transition across the CAMHS/AMHS boundary. This study protocol describes the process of development of two new transition measures: the TRAM and TROM. The TRAM has the potential to nurture better transitions as the findings can be summarised and provided to clinicians as a clinician-decision making support tool for identifying cases who need to transition and the TROM can be used to examine the outcomes of the transition process. Trial registration: MILESTONE study registration: ISRCTN83240263 Registered 23-July-2015 - ClinicalTrials.gov NCT03013595 Registered 6 January 2017