Systematic review and meta-analysis of the provision of preventive care for modifiable chronic disease risk behaviours by mental health services

People with mental illness experience increased chronic disease burden, contributed to by a greater prevalence of modifiable chronic disease risk behaviours. Policies recommend mental health services provide preventive care for such risk behaviours. Provision of such care has not previously been synthesised. This review assessed the provision of preventive care for modifiable chronic disease risk behaviours by mental health services. Four databases were searched from 2006 to 2017. Eligible studies were observational quantitative study designs conducted in mental health services, where preventive care was provided to clients for tobacco smoking, harmful alcohol consumption, inadequate nutrition, or inadequate physical activity. Two reviewers independently screened studies, conducted data extraction and critical appraisal. Results were pooled as proportions of clients receiving or clinicians providing preventive care using random effects meta-analyses, by risk behaviour and preventive care element (ask/assess, advise, assist, arrange). Subgroup analyses were conducted by mental health service type (inpatient, outpatient, other/multiple). Narrative synthesis was used where meta-analysis was not possible. Thirty-eight studies were included with 26 amenable to meta-analyses. Analyses revealed that rates of assessment were highest for smoking (78%, 95% confidence interval [CI]:59%–96%) and lowest for nutrition (17%, 95% CI:1%–35%); with variable rates of care provision for all behaviours, care elements, and across service types, with substantial heterogeneity across analyses. Findings indicated suboptimal and variable provision of preventive care for modifiable chronic disease risk behaviours in mental health services, but should be considered with caution due to the very low quality of cumulative evidence

Predictors of contraction and expansion of area of occupancy for British birds

Copyright © 2014 The Author(s) Published by the Royal SocietyGeographical range dynamics are driven by the joint effects of abiotic factors, human ecosystem modifications, biotic interactions and the intrinsic organismal responses to these. However, the relative contribution of each component remains largely unknown. Here, we compare the contribution of life-history attributes, broad-scale gradients in climate and geographical context of species’ historical ranges, as predictors of recent changes in area of occupancy for 116 terrestrial British breeding birds (74 contractors, 42 expanders) between the early 1970s and late 1990s. Regional threat classifications demonstrated that the species of highest conservation concern showed both the largest contractions and the smallest expansions. Species responded differently to climate depending on geographical distribution—northern species changed their area of occupancy (expansion or contraction) more in warmer and drier regions, whereas southern species changed more in colder and wetter environments. Species with slow life history (larger body size) tended to have a lower probability of changing their area of occupancy than species with faster life history, whereas species with greater natal dispersal capacity resisted contraction and, counterintuitively, expansion. Higher geographical fragmentation of species' range also increased expansion probability, possibly indicating a release from a previously limiting condition, for example through agricultural abandonment since the 1970s. After accounting statistically for the complexity and nonlinearity of the data, our results demonstrate two key aspects of changing area of occupancy for British birds: (i) climate is the dominant driver of change, but direction of effect depends on geographical context, and (ii) all of our predictors generally had a similar effect regardless of the direction of the change (contraction versus expansion). Although we caution applying results from Britain's highly modified and well-studied bird community to other biogeographic regions, our results do indicate that a species' propensity to change area of occupancy over decadal scales can be explained partially by a combination of simple allometric predictors of life-history pace, average climate conditions and geographical context.Australian Research CouncilIntegrated Program of IC&DTFCT (Fundação para a Ciência e a Tecnologia

Ramsar Wetlands of International Importance–improving conservation outcomes

The Ramsar Convention (or the Convention on Wetlands), signed in 1971, was one of the first international conservation agreements, promoting global wise use of wetlands. It has three primary objectives: national designation and management of wetlands of international importance; general wise use of wetlands; and international cooperation. We examined lessons learnt for improving wetland conservation after Ramsar’s nearly five decades of operation. The number of wetlands in the Ramsar Site Network has grown over time (2,391 Ramsar Sites, 2.5 million km2, as at 2020-06-09) but unevenly around the world, with decreasing rate of growth in recent decades. Ramsar Sites are concentrated in countries with a high Gross Domestic Product and human pressure (e.g., western Europe) but, in contrast, Ramsar Sites with the largest wetland extent are in central-west Africa and South America. We identified three key challenges for improving effectiveness of the Ramsar Site Network: increasing number of sites and wetland area, improved representation (functional, geographical and biological); and effective management and reporting. Increasing the number of sites and area in the Ramsar network could benefit from targets, implemented at national scales. Knowledge of representativeness is inadequate, requiring analyses of functional ecotypes, geographical and biological representativeness. Finally, most countries have inadequate management planning and reporting on the ecological character of their Ramsar Sites, requiring more focused attention on a vision and objectives, with regular reporting of key indicators to guide management. There are increasing opportunities to rigorously track ecological character, utilizing new tools and available indicators (e.g., remote sensing). It is critical that the world protect its wetlands, with an effective Ramsar Convention or the Convention on Wetlands at the core

Patient-Reported Morbidity Instruments: A Systematic Review

Objectives: Although comorbidities play an essential role in risk adjustment and outcomes measurement, there is little consensus regarding the best source of this data. The aim of this study was to identify general patient-reported morbidity instruments and their measurement properties. Methods: A systematic review was conducted using multiple electronic databases (Embase, Medline, Cochrane Central, and Web of Science) from inception to March 2018. Articles focusing primarily on the development or subsequent validation of a patient-reported morbidity instrument were included. After including relevant articles, the measurement properties of each morbidity instrument were extracted by 2 investigators for narrative synthesis. Results: A total of 1005 articles were screened, of which 34 eligible articles were ultimately included. The most widely assessed instruments were the Self-Reported Charlson Comorbidity Index (n = 7), the Self-Administered Comorbidity Questionnaire (n = 3), and the Disease Burden Morbidity Assessment (n = 3). The most commonly included conditions were diabetes, hypertension, and myocardial infarction. Studies demonstrated substantial variability in item-level reliability versus the gold standard medical record review (κ range 0.66-0.86), meaning that the accuracy of the self-reported comorbidity data is dependent on the selected morbidity. Conclusions: The Self-Reported Charlson Comorbidity Index and the Self-Administered Comorbidity Questionnaire were the most frequently cited instruments. Significant variability was observed in reliability per comorbid condition of patient-reported morbidity questionnaires. Further research is needed to determine whether patient-reported morbidity data should be used to bolster medical records data or serve as a stand-alone entity when risk adjusting observational outcomes data

Argon K-shell and bound-free emission from OMEGA direct-drive implosion cores

We discuss calculations of synthetic spectra for the interpretation and analysis of K-shell and bound-free emission from argon-doped deuterium-filled OMEGA direct-drive implosion cores. The spectra are computed using a model that considers collisional-radiative atomic kinetics, continuum-lowering, detailed Stark-broadened line shapes, line overlapping, and radiation transport effects. The photon energy range covers the moderately optically thick n = 3 → n = 1 and n = 4 → n = 1 line transitions in He- and H-like Ar, their associated satellite lines in Li- and He-like Ar, and several radiative recombination edges. At the high-densities characteristic of implosion cores, the radiative recombination edges substantially shift to lower energies thus overlapping with several line transitions. We discuss the application of the spectra to spectroscopic analysis of doped implosion core

An epitaxial model for heterogeneous nucleation on potent substrates

© The Minerals, Metals & Materials Society and ASM International 2012In this article, we present an epitaxial model for heterogeneous nucleation on potent substrates. It is proposed that heterogeneous nucleation of the solid phase (S) on a potent substrate (N) occurs by epitaxial growth of a pseudomorphic solid (PS) layer on the substrate surface under a critical undercooling (ΔT ). The PS layer with a coherent PS/N interface mimics the atomic arrangement of the substrate, giving rise to a linear increase of misfit strain energy with layer thickness. At a critical thickness (h ), elastic strain energy reaches a critical level, at which point, misfit dislocations are created to release the elastic strain energy in the PS layer. This converts the strained PS layer to a strainless solid (S), and changes the initial coherent PS/N interface into a semicoherent S/N interface. Beyond this critical thickness, further growth will be strainless, and solidification enters the growth stage. It is shown analytically that the lattice misfit (f) between the solid and the substrate has a strong influence on both h and ΔT ; h decreases; and ΔT increases with increasing lattice misfit. This epitaxial nucleation model will be used to explain qualitatively the generally accepted experimental findings on grain refinement in the literature and to analyze the general approaches to effective grain refinement.EPSRC Centre for Innovative Manufacturing in Liquid Metal Engineerin

A New Parametrization of the Seesaw Mechanism and Applications in Supersymmetric Models

We present a new parametrization of the minimal seesaw model, expressing the heavy-singlet neutrino Dirac Yukawa couplings $(Y_\nu)_{ij}$ and Majorana masses $M_{N_i}$ in terms of effective light-neutrino observables and an auxiliary Hermitian matrix $H.$ In the minimal supersymmetric version of the seesaw model, the latter can be related directly to other low-energy observables, including processes that violate charged lepton flavour and CP. This parametrization enables one to respect the stringent constraints on muon-number violation while studying the possible ranges for other observables by scanning over the allowed parameter space of the model. Conversely, if any of the lepton-flavour-violating process is observed, this measurement can be used directly to constrain $(Y_\nu)_{ij}$ and $M_{N_i}.$ As applications, we study flavour-violating $\tau$ decays and the electric dipole moments of leptons in the minimal supersymmetric seesaw model.Comment: Important references adde

PRIMA1 mutation: A new cause of nocturnal frontal lobe epilepsy

Objective Nocturnal frontal lobe epilepsy (NFLE) can be sporadic or autosomal dominant; some families have nicotinic acetylcholine receptor subunit mutations. We report a novel autosomal recessive phenotype in a single family and identify the causative gene. Methods Whole exome sequencing data was used to map the family, thereby narrowing exome search space, and then to identify the mutation. Results Linkage analysis using exome sequence data from two affected and two unaffected subjects showed homozygous linkage peaks on chromosomes 7, 8, 13, and 14 with maximum LOD scores between 1.5 and 1.93. Exome variant filtering under these peaks revealed that the affected siblings were homozygous for a novel splice site mutation (c.93+2T>C) in the PRIMA1 gene on chromosome 14. No additional PRIMA1 mutations were found in 300 other NFLE cases. The c.93+2T>C mutation was shown to lead to skipping of the first coding exon of the PRIMA1 mRNA using a minigene system. Interpretation PRIMA1 is a transmembrane protein that anchors acetylcholinesterase (AChE), an enzyme hydrolyzing acetycholine, to membrane rafts of neurons. PRiMA knockout mice have reduction of AChE and accumulation of acetylcholine at the synapse; our minigene analysis suggests that the c.93+2T>C mutation leads to knockout of PRIMA1. Mutations with gain of function effects in acetylcholine receptor subunits cause autosomal dominant NFLE. Thus, enhanced cholinergic responses are the likely cause of the severe NFLE and intellectual disability segregating in this family, representing the first recessive case to be reported and the first PRIMA1 mutation implicated in disease