Temporal patterns in the recorded annual incidence of common mental disorders over two decades in the United Kingdom: a primary care cohort study

BACKGROUND: Common mental disorders (CMDs) including depression, anxiety, and stress are very common, but it is unclear whether the last decades of social, economic, and political change have impacted incidence of CMD. This study explored temporal trends in the recorded incidence of CMD in the United Kingdom. METHODS: We used data from general practices in the United Kingdom (Clinical Practice Research Datalink) to estimate the annual recorded incidence of CMD for 2000-2020, including symptoms, diagnosis, or pharmaceutical treatment. Trends were explored by sex, age, ethnicity, region, deprivation, and comorbidity. RESULTS: We included 29 480 164 individuals who were followed up for 12.5 years on average (s.d. = 6.4 years). The recorded incidence of CMD episodes was 55.9 per 1000 person-years in 2000 [95% confidence interval (CI) 55.8-56.1], increasing to 79.6 per 1000 person-years in 2019 (95% CI 79.5-79.8). Females had higher recorded incidence rates, as did those living in more deprived areas. We observed striking patterns by age over time, with rates in ages 16-24 increasing from 40.2 per 1000 in 2000 (95% CI 39.8-40.5), to 107.8 per 1000 in 2019 (95% CI 107.0-108.6). In contrast, the rates in those aged ≥55 years decreased since 2014. There were differing patterns of incidence by ethnic group, with a steeper increase in Asian, Black, and mixed groups in recent years. CONCLUSIONS: Overall, the incidence of recorded CMD in the UK general practice increased between 2000 and 2019 with a small decrease in 2020. The overall trends obscured important differences across population subgroups, which may have implications for prevention

Temporal patterns in the recorded annual incidence of common mental disorders over two decades in the United Kingdom: a primary care cohort study

BACKGROUND: Common mental disorders (CMDs) including depression, anxiety, and stress are very common, but it is unclear whether the last decades of social, economic, and political change have impacted incidence of CMD. This study explored temporal trends in the recorded incidence of CMD in the United Kingdom. METHODS: We used data from general practices in the United Kingdom (Clinical Practice Research Datalink) to estimate the annual recorded incidence of CMD for 2000-2020, including symptoms, diagnosis, or pharmaceutical treatment. Trends were explored by sex, age, ethnicity, region, deprivation, and comorbidity. RESULTS: We included 29 480 164 individuals who were followed up for 12.5 years on average (s.d. = 6.4 years). The recorded incidence of CMD episodes was 55.9 per 1000 person-years in 2000 [95% confidence interval (CI) 55.8-56.1], increasing to 79.6 per 1000 person-years in 2019 (95% CI 79.5-79.8). Females had higher recorded incidence rates, as did those living in more deprived areas. We observed striking patterns by age over time, with rates in ages 16-24 increasing from 40.2 per 1000 in 2000 (95% CI 39.8-40.5), to 107.8 per 1000 in 2019 (95% CI 107.0-108.6). In contrast, the rates in those aged ≥55 years decreased since 2014. There were differing patterns of incidence by ethnic group, with a steeper increase in Asian, Black, and mixed groups in recent years. CONCLUSIONS: Overall, the incidence of recorded CMD in the UK general practice increased between 2000 and 2019 with a small decrease in 2020. The overall trends obscured important differences across population subgroups, which may have implications for prevention

LArPix: Demonstration of low-power 3D pixelated charge readout for liquid argon time projection chambers

We report the demonstration of a low-power pixelated readout system designed for three-dimensional ionization charge detection and digital readout of liquid argon time projection chambers (LArTPCs). Unambiguous 3D charge readout was achieved using a custom-designed system-on-a-chip ASIC (LArPix) to uniquely instrument each pad in a pixelated array of charge-collection pads. The LArPix ASIC, manufactured in 180 nm bulk CMOS, provides 32 channels of charge-sensitive amplification with self-triggered digitization and multiplexed readout at temperatures from 80 K to 300 K. Using an 832-channel LArPix-based readout system with 3 mm spacing between pads, we demonstrated low-noise ($<$500 e$^-$ RMS equivalent noise charge) and very low-power ($<$100 $\mu$W/channel) ionization signal detection and readout. The readout was used to successfully measure the three-dimensional ionization distributions of cosmic rays passing through a LArTPC, free from the ambiguities of existing projective techniques. The system design relies on standard printed circuit board manufacturing techniques, enabling scalable and low-cost production of large-area readout systems using common commercial facilities. This demonstration overcomes a critical technical obstacle for operation of LArTPCs in high-occupancy environments, such as the near detector site of the Deep Underground Neutrino Experiment (DUNE).Comment: 19 pages, 10 figures, 1 ancillary animation. V3 includes minor revisions based on referee comment

Are we stripping the care out of care plans?

In 2013, NHS England specified that: "‘... every person with a long-term condition or disability has a personalised care plan supporting them to develop the knowledge, skills and confidence to manage their own health’.1" Around 40% of the UK population experience a long-term condition while 65% of people aged 65–84 years have two or more.2 This is an all-time high, with figures set to rise. This places significant personal, social, and economic burden on individuals, their families, and the community. The use of care plans to manage multiple long-term conditions — by assessing individual behaviour, setting joint goals, supporting self-management, and ensuring proactive follow-up — is based on Wagner’s Chronic Care Model.3 The model takes into account the need to provide support and structure to patients, and the fact that all long-term conditions have common challenges. Care planning has received extraordinary interest in the NHS. Policymakers endorse care planning as a way of containing high costs, encouraging a more person-centred approach, improving quality of life, and reducing mortality rates and emergency admissions to hospitals. But are care plans effective in this regard and what challenges do GP practices face in implementation

Low power discriminator for ATLAS pixel chip

The design of the front-end (FE) pixel electronics requires low power, low noise and low threshold dispersion. In this work, we propose a new architecture for the discriminator circuit. It is based on the principle of dynamic biasing and developed for the FE chip of the ATLAS pixel upgrade. This paper presents two discriminator structures where the bias current depends on the presence of a signal at the input of the discriminator. Since the activity in the FE chip is very low, the power consumption is largely reduced allowing the material reduction in the B-layer

Community-centred interventions for improving public mental health among adults from ethnic minority populations in the UK: A scoping review

OBJECTIVES: Undertake a scoping review to determine the effectiveness of community-centred interventions designed to improve the mental health and well-being of adults from ethnic minority groups in the UK. METHODS: We searched six electronic academic databases for studies published between January 1990 and September 2019: Medline, Embase, PsychINFO, Scopus, CINAHL and Cochrane. For intervention description and data extraction we used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist and Template for Intervention Description and Replication guide. Quality was assessed using Cochrane risk of bias tools. Grey literature results were deemed beyond the scope of this review due to the large number of interventions and lack of available outcomes data. RESULTS: Of 4501 studies, 7 met the eligibility criteria of UK-based community interventions targeting mental health in adults from ethnic minority populations: four randomised controlled trials, one pre/post-pilot study, one cross-sectional study and one ethnographic study. Interventions included therapy-style sessions, peer-support groups, educational materials, gym access and a family services programme. Common components included a focus on tackling social isolation, using lay health workers from within the community, signposting and overcoming structural barriers to access. Four studies reported a statistically significant positive effect on mental health outcomes and six were appraised as having a high risk of bias. Study populations were ethnically heterogeneous and targeted people mainly from South Asia. No studies examined interventions targeting men. CONCLUSIONS: There is a paucity of high-quality evidence regarding community-centred interventions focused on improving public mental health among ethnic minority groups. Decision makers need scientific evidence to inform effective approaches to mitigating health disparities. Our next steps are to map promising community activities and interventions that are currently being provided to help identify emerging evidence

Charge Pump Clock Generation PLL for the Data Output Block of the Upgraded ATLAS Pixel Front-End in 130 nm CMOS

FE-I4 is the 130 nm ATLAS pixel IC currently under development for upgraded Large Hadron Collider (LHC) luminosities. FE-I4 is based on a low-power analog pixel array and digital architecture concepts tuned to higher hit rates [1]. An integrated Phase Locked Loop (PLL) has been developed that locally generates a clock signal for the 160 Mbit/s output data stream from the 40 MHz bunch crossing reference clock. This block is designed for low power, low area consumption and recovers quickly from loss of lock related to single-event transients in the high radiation environment of the ATLAS pixel detector. After a general introduction to the new FE-I4 pixel front-end chip, this work focuses on the FE-I4 output blocks and on a first PLL prototype test chip submitted in early 2009. The PLL is nominally operated from a 1.2V supply and consumes 3.84mW of DC power. Under nominal operating conditions, the control voltage settles to within 2% of its nominal value in less than 700 ns. The nominal operating frequency for the ring-oscillator based Voltage Controlled Oscillator (VCO) is fVCO = 640MHz. The last sections deal with a fabricated demonstrator that provides the option of feeding the single-ended 80MHz output clock of the PLL as a clock signal to a digital test logic block integrated on-chip. The digital logic consists of an eight bit pseudo-random binary sequence generator, an eight bit to ten bit coder and a serializer. It processes data with a speed of 160 Mbit/s. All dynamic signals are driven off-chip by custommade pseudo-LVDS drivers

Prototype ATLAS IBL Modules using the FE-I4A Front-End Readout Chip

The ATLAS Collaboration will upgrade its semiconductor pixel tracking detector with a new Insertable B-layer (IBL) between the existing pixel detector and the vacuum pipe of the Large Hadron Collider. The extreme operating conditions at this location have necessitated the development of new radiation hard pixel sensor technologies and a new front-end readout chip, called the FE-I4. Planar pixel sensors and 3D pixel sensors have been investigated to equip this new pixel layer, and prototype modules using the FE-I4A have been fabricated and characterized using 120 GeV pions at the CERN SPS and 4 GeV positrons at DESY, before and after module irradiation. Beam test results are presented, including charge collection efficiency, tracking efficiency and charge sharing.Comment: 45 pages, 30 figures, submitted to JINS

Design of analog front-ends for the RD53 demonstrator chip

The RD53 collaboration is developing a large scale pixel front-end chip, which will be a tool to evaluate the performance of 65 nm CMOS technology in view of its application to the readout of the innermost detector layers of ATLAS and CMS at the HL-LHC. Experimental results of the characterization of small prototypes will be discussed in the frame of the design work that is currently leading to the development of the large scale demonstrator chip RD53A to be submitted in early 2017. The paper is focused on the analog processors developed in the framework of the RD53 collaboration, including three time over threshold front-ends, designed by INFN Torino and Pavia, University of Bergamo and LBNL and a zero dead time front-end based on flash ADC designed by a joint collaboration between the Fermilab and INFN. The paper will also discuss the radiation tolerance features of the front-end channels, which were exposed to up to 800 Mrad of total ionizing dose to reproduce the system operation in the actual experiment