NICE shared decision making guidelines and mental health: challenges for research, practice and implementation

The National Institute for Health and Care Excellence (NICE) initiated an ambitious effort to develop the first shared decision making guidelines. The purpose of this commentary is to identify three main concerns pertaining to the new published guidelines for shared decision making research, practice, implementation and cultural differences in mental health

Supersymmetry Breaking in the Early Universe

Supersymmetry breaking in the early universe induces scalar soft potentials with curvature of order the Hubble constant. This has a dramatic effect on the coherent production of scalar fields along flat directions. For the moduli problem it generically gives a concrete realization of the problem by determining the field value subsequent to inflation. However it might suggest a solution if the minimum of the induced potential coincides with the true minimum. The induced Hubble scale mass also has important implications for the Affleck-Dine mechanism of baryogenesis. This mechanism requires large squark or slepton expectation values to develop along flat directions in the early universe. This is generally not the case if the induced mass squared is positive, but does occur if it is negative. The resulting baryon to entropy ratio depends mainly on the dimension of the nonrenormalizable operator in the superpotential which stabilizes the flat direction, and the reheat temperature after inflation. Unlike the original scenario, it is possible to obtain an acceptable baryon asymmetry without subsequent entropy releases.Comment: 11 pages, requires phyzz

Facilitating treatment engagement for early psychosis through peer-delivered decision support : Intervention development and protocol for pilot evaluation

Background: Emerging adults with early psychosis demonstrate high rates of service disengagement from critical early intervention services. Decision support interventions and peer support have both been shown to enhance service engagement but are understudied in this population. The purposes of this article are to describe the development of a novel peer-delivered decision coaching intervention for this population and to report plans for a pilot study designed to gather preliminary data about its feasibility, acceptability, and potential impact. Methods: The intervention was developed based on formative qualitative data and in collaboration with a diverse team of researchers, key stakeholders, and expert consultants. The pilot trial will utilize a single-group (N = 20), pre-post, convergent mixed-methods design to explore whether and how the intervention addresses decision-making needs (the primary intervention target). The impact of the intervention on secondary outcomes (e.g., engagement in the program) will also be assessed. Additionally, through observation and feedback from the peer decision coach and study participants, we will evaluate the feasibility of research and intervention procedures, and the acceptability of information and support from the peer decision coach. Discussion: The peer-delivered decision coaching intervention holds promise for assisting young people with making informed and values-consistent decisions about their care, and potentially enhancing service engagement within this traditionally difficult-to-engage population. If the intervention demonstrates feasibility and acceptability, and pilot data show its potential for improving treatment decision-making, our work will also lay the foundation for a new evidence base regarding roles for peer specialists on early intervention teams

Detection of a Westward Hotspot Offset in the Atmosphere of a Hot Gas Giant CoRoT-2b

Short-period planets exhibit day-night temperature contrasts of hundreds to thousands of degrees K. They also exhibit eastward hotspot offsets whereby the hottest region on the planet is east of the substellar point; this has been widely interpreted as advection of heat due to eastward winds. We present thermal phase observations of the hot Jupiter CoRoT-2b obtained with the IRAC instrument on the Spitzer Space Telescope. These measurements show the most robust detection to date of a westward hotspot offset of 23 $\pm$ 4 degrees, in contrast with the nine other planets with equivalent measurements. The peculiar infrared flux map of CoRoT-2b may result from westward winds due to non-synchronous rotation magnetic effects, or partial cloud coverage, that obscures the emergent flux from the planet's eastern hemisphere. Non-synchronous rotation and magnetic effects may also explain the planet's anomalously large radius. On the other hand, partial cloud coverage could explain the featureless dayside emission spectrum of the planet. If CoRoT-2b is not tidally locked, then it means that our understanding of star-planet tidal interaction is incomplete. If the westward offset is due to magnetic effects, our result represents an opportunity to study an exoplanet's magnetic field. If it has Eastern clouds, then it means that our understanding of large-scale circulation on tidally locked planets is incomplete.Comment: 30 pages, 4 figures, 15 supplementary figure

Psychiatric symptoms and moral injury among US healthcare workers in the COVID-19 era

Background Emerging cross-sectional data indicate that healthcare workers (HCWs) in the COVID-19 era face particular mental health risks. Moral injury – a betrayal of one’s values and beliefs, is a potential concern for HCWs who witness the devastating impact of acute COVID-19 illness while too often feeling helpless to respond. This study longitudinally examined rates of depression, generalized anxiety disorder (GAD), posttraumatic stress disorder (PTSD), and moral injury among United States HCWs in the COVID-19 era. We anticipated finding high levels of clinical symptoms and moral injury that would remain stable over time. We also expected to find positive correlations between clinical symptoms and moral injury. Methods This three-wave study assessed clinical symptoms and moral injury among 350 HCWs at baseline, 30, and 90 days between September and December 2020. Anxiety, depression, PTSD, and moral injury were measured using the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Primary Care PTSD Screen (PC-PTSD), and Moral Injury Events Scale (MIES). Results Of the 350 HCWs, 72% reported probable anxiety, depression, and/or PTSD disorders at baseline, 62% at day 30, and 64% at day 90. High level of moral injury was associated with a range of psychopathology including suicidal ideation, especially among healthcare workers self-reporting COVID-19 exposure. Conclusions Findings demonstrate broad, persisting, and diverse mental health consequences of the COVID-19 pandemic among United States HCWs. This study is the first to longitudinally examine the relationships between moral injury and psychopathology among HCWs, emphasizing the need to increase HCWs’ access to mental healthcare

From weak coupling to spinning strings

We identify the gauge theory dual of a spinning string of minimal energy with spins S_1, S_2 on AdS_5 and charge J on S^5. For this purpose we focus on a certain set of local operators with two different types of covariant derivatives acting on complex scalar fields. We analyse the corresponding nested Bethe equations for the ground states in the limit of large spins. The auxiliary Bethe roots form certain string configurations in the complex plane, which enable us to derive integral equations for the leading and sub-leading contribution to the anomalous dimension. The results can be expressed through the observables of the sl(2) sub-sector, i.e. the cusp anomaly f(g) and the virtual scaling function B_L(g), rendering the strong-coupling analysis straightforward. Furthermore, we also study a particular sub-class of these operators specialising to a scaling limit with finite values of the second spin at weak and strong coupling.Comment: 23 pages, 3 figures, minor changes, references adde

The Practitioner's Dilemma: How to Assess the Credibility of Downscaled Climate Projections

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/101803/1/eost2013EO460005.pd