Common mental disorders and mortality in the West of Scotland Twenty-07 Study: comparing the General Health Questionnaire and the Hospital Anxiety and Depression Scale

Background While various measures of common mental disorders (CMD) have been found to be associated with mortality, a comparison of how different measures predict mortality may improve our understanding of the association. This paper compares how the Hospital Anxiety and Depression Scale (HADS) and the 30-item General Health Questionnaire (GHQ-30) predict all cause and cause-specific mortality. Methods Data on 2547 men and women from two cohorts, aged approximately 39 and 55 years, from the West of Scotland Twenty-07 Study who were followed up for mortality over an average of 18.9 (SD 5.0) years. Scores were calculated for HADS depression (HADS-D), HADS Anxiety (HADS-A) and GHQ-30. Cox Proportional Hazards Models were used to determine how each CMD measure predicted mortality. Results After adjusting for serious physical illness, smoking, social class, alcohol, obesity, pulse rate and living alone, HRs (95% CI) per SD increase in score for all-cause mortality were: 1.15 (1.07 to 1.25) for HADSD; 1.13 (1.04 to 1.23) for GHQ-30 and 1.05 (0.96 to 1.14) for HADS-A. After the same adjustments, cardiovascular disease mortality was also related to HADS-D (HR 1.24 (1.07 to 1.43)), to GHQ-30 (HR 1.24 (1.11 to 1.40)) and to HADS-A (HR 1.15 (1.01 to 1.32)); respiratory mortality to GHQ-30 (HR 1.33 (1.13 to 1.55)) and mortality from other causes, excluding injuries, to HADS-D (HR 1.28 (1.05 to 1.55)). Conclusions There were associations between CMD and both all-cause and cause-specific mortality which were broadly similar for GHQ-30 and HADS-D and were still present after adjustment for important confounders and mediators

Drivers and barriers to acceptance of human-papillomavirus vaccination among young women: a qualitative and quantitative study

<p>Abstract</p> <p>Background</p> <p>Human papillomavirus (HPV) is a necessary cause of cervical dysplasia and cancer, and of genital warts. Few studies have examined attitudes to HPV vaccination since the introduction of HPV vaccines. We aimed to investigate the reasons for young women's acceptance or rejection of the quadrivalent HPV vaccine after its general availability in Denmark.</p> <p>Method</p> <p>A literature review assessed attitudes towards HPV vaccination and the information was used to identify relevant questions for telephone and focus group interviews with women aged 16-26 who had decided to receive or reject HPV vaccination. 435 women across Denmark were interviewed by telephone. Qualitative interviews were undertaken in focus groups with 33 women living in Odense who had completed the telephone survey. Four focus groups were set up according to age (16-20 and 21-26 years of age) and acceptance/rejection of the vaccine.</p> <p>Results</p> <p>Of 839 women initially contacted by telephone, 794 were included, 411 (49%) said they accepted vaccination but only 201 (24%) had actually received the vaccine and these latter were interviewed. 242 women said they refused vaccination of which 234 were interviewed. Women who were undecided were excluded from the study. Prevention of cervical cancer was the main driver for acceptance of the vaccine, followed by parental encouragement and financial support, personal experience of someone with cancer and recommendation by health-care professionals. The greatest barrier to vaccination was its cost. A lack of information about the benefits of vaccination for sexually active women was also an important barrier and the older participants in particular considered that they were too old to be vaccinated. Knowledge about HPV and its role in the development of cervical cancer and genital warts was poor.</p> <p>Conclusions</p> <p>The difference between intention to be vaccinated and starting vaccination was considerable, and a large proportion of women aged 16-26 did not wish to be vaccinated. If the most important barriers to vaccination were addressed (cost and a lack of information about vaccination benefits), it is likely that the uptake of vaccination in Denmark would increase substantially.</p

The effectiveness of classroom vocabulary intervention for adolescents with language disorder

Purpose Phonological-semantic intervention has been shown to be effective in enhancing the vocabulary skills of children with language disorder in small-group or individual settings. Less is known about vocabulary interventions for adolescents with language disorder in whole-class models of delivery. The current study investigated the effectiveness of phonological-semantic vocabulary intervention for adolescents with language disorder, delivered by secondary school teachers within science lessons. Methods Seventy-eight adolescents with language disorder, aged 11 – 13 years, were taught science curriculum words by teachers in class, under two conditions: 1) 10 words taught through usual teaching practice; and 2) 10 matched words taught using an experimental intervention known as Word Discovery, which embedded phonological-semantic activities into the teaching of the syllabus. Ten similar control words received no intervention. Word knowledge was assessed pre-intervention, post-intervention, and follow-up. Results At pre-intervention, measures of depth of word knowledge and expressive word use did not differ between usual teaching practice and experimental words. At post-intervention, depth of knowledge of experimental words was significantly greater than that of usual teaching practice words. This significant advantage was not maintained at follow-up, although depth of knowledge for experimental words remained significantly higher at follow-up than at preintervention. At post-intervention, expressive use of experimental words was significantly greater than that of usual teaching practice words, and this significant difference was maintained at follow-up. There was no change in students’ depth of knowledge or expressive use of no-intervention words over time, confirming that the findings were not due to maturity or practice effects. Conclusion The experimental intervention was more effective than usual teaching practice in increasing the word knowledge of participants. Clinical and teaching implications include the importance of intervening during the adolescent years, with classroom vocabulary intervention being a viable option for collaborative teacher and speech and language therapy/pathology practice

Lake drying and livelihood dynamics in Lake Chad: unravelling the mechanisms, contexts and responses

This article examines lake drying and livelihood dynamics in the context of multiple stressors through a case study of the ‘‘Small Lake Chad’’ in the Republic of Chad. Livelihoods research in regions experiencing persistent lake water fluctuations has largely focused on the wellbeing and security of lakeshore dwellers. Little is known about the mechanisms through which lake drying shapes livelihood drawbacks and opportunities, and whether locally evolved responses are enhancing livelihoods. Here we address these gaps using empirical, mixed-methods field research couched within the framework of livelihoods and human well-being contexts. The analysis demonstrates that limited opportunities outside agriculture, the influx of mixed ethnic migrants and the increasing spate of violence all enhance livelihood challenges. Livelihood opportunities centre on the renewal effects of seasonal flood pulses on lake waters and the learning opportunities triggered by past droughts. Although drying has spurred new adaptive behaviours predicated on seasonality, traditional predictive factors and the availability of assets, responses have remained largely reactive. The article points to where lake drying fits amongst changes in the wider socioeconomic landscape in which people live, and suggests that awareness of the particularities of the mechanisms that connect lake drying to livelihoods can offer insights into the ways local people might be assisted by governments and development actors

Weight-Loss Maintenance in Overweight Individuals One to Five Years Following Successful Completion of a Commercial Weight Loss Program

OBJECTIVE: To determine weight loss maintenance among participants in a commercial weight loss program (Weight Watchers) who had reached their goal weights 1-5 y previously. DESIGN: A national sample (n=1002) was surveyed by phone to obtain demographic and weight-related information. An oversample (n=258) was recruited and weighed in person to develop a correction factor for self-reported weights in the national sample. RESULTS: Based on corrected weights, weight regain from 1 to 5 y following weight loss ranged between 31.5 and 76.5%. At 5 y, 19.4% were within 5 lb of goal weight, 42.6% maintained a loss of 5% or more, 18.8% maintained a loss of 10% or more, and 70.3% were below initial weight. CONCLUSIONS: These results are not directly comparable to those obtained in clinical settings because of differences in the populations studied. Nonetheless, they suggest that the long-term prognosis for weight maintenance among individuals who reach goal weight in at least one commercial program is better than that suggested by existing research

Wetlands for wastewater treatment and subsequent recycling of treated effluent : a review

Due to water scarcity challenges around the world, it is essential to think about non-conventional water resources to address the increased demand in clean freshwater. Environmental and public health problems may result from insufficient provision of sanitation and wastewater disposal facilities. Because of this, wastewater treatment and recycling methods will be vital to provide sufficient freshwater in the coming decades, since water resources are limited and more than 70% of water are consumed for irrigation purposes. Therefore, the application of treated wastewater for agricultural irrigation has much potential, especially when incorporating the reuse of nutrients like nitrogen and phosphorous, which are essential for plant production. Among the current treatment technologies applied in urban wastewater reuse for irrigation, wetlands were concluded to be the one of the most suitable ones in terms of pollutant removal and have advantages due to both low maintenance costs and required energy. Wetland behavior and efficiency concerning wastewater treatment is mainly linked to macrophyte composition, substrate, hydrology, surface loading rate, influent feeding mode, microorganism availability, and temperature. Constructed wetlands are very effective in removing organics and suspended solids, whereas the removal of nitrogen is relatively low, but could be improved by using a combination of various types of constructed wetlands meeting the irrigation reuse standards. The removal of phosphorus is usually low, unless special media with high sorption capacity are used. Pathogen removal from wetland effluent to meet irrigation reuse standards is a challenge unless supplementary lagoons or hybrid wetland systems are used

Public Preferences for Forest Ecosystem Management in Japan with Emphasis on Species Diversity

We carried out online choice experiments (CE) to investigate what value Japanese individuals assign to rare versus familiar species in forest ecosystem, and to determine how preference heterogeneity arises. CE attributes comprised a forestry charge as the price attribute and rare versus familiar species of animals or plants as the good to be valued. Species numbers in a 5 km-mesh forest area were evaluated without the use of species names to focus purely on responses to numerical changes. Positional effects were also tested to validate results regarding alternatives and attributes other than the price attribute. A random parameter logit model was adopted to capture preferences for species diversity. After confirming that no positional effects existed, we found that (1) rare animals were valued more highly than rare plants, (2) familiar plants were assigned a positive value, but familiar animals were not assigned significant value at the mean parameter estimate, and (3) preference heterogeneities existed for all species. The sources of preference heterogeneity were analyzed with a latent class model having principal components of environmental attitudes. The influence of such attitudes was shown to be significant and suggested that attention should be paid to belief systems rather than solely demographics