Postdeployment Battlemind training for the U.K. armed forces: a cluster randomized controlled trial

OBJECTIVE: Combat exposure can increase the risk of subsequent psychological ill-health in armed forces (AF) personnel. A U.S. postdeployment psycho-educational intervention, Battlemind, showed a beneficial effect on mental health in U.S. military personnel exposed to high combat levels. We evaluated the effectiveness of an anglicized version of postdeployment Battlemind. METHOD: Battlemind was adapted for the United Kingdom. The main amendments were to sections about carrying weapons, driving, and alcohol misuse. The anglicized Battlemind was compared with the U.K. standard postdeployment brief in a cluster randomized controlled trial. At baseline, 2,443 U.K. AF personnel returning from Afghanistan via Cyprus completed questionnaires about their combat experiences and mental health. Of these, 1,616 (66%) completed 6-month follow-up questionnaires. We used the Posttraumatic Stress Disorder Checklist (PCL-C) to measure probable posttraumatic stress disorder and the General Health Questionnaire (GHQ-12) to measure common mental disorders. Secondary outcomes included alcohol misuse, assessed with the Alcohol Use Disorders Identification Test (AUDIT), and binge drinking. Mixed-effects models were used to account for possible cluster effects. RESULTS: We did not find a difference in mental health or overall AUDIT score. Those who received Battlemind versus the standard brief were less likely to report binge drinking, although the effect size was small (adjusted odds ratio = 0.73, 95% CI [0.58, 0.92]). CONCLUSIONS: The anglicized Battlemind did not improve mental health but had a modest impact on the reporting of binge drinking. Alcohol misuse is problematic in military populations; therefore, an intervention that reduces binge drinking may be helpful

Sustainable oral healthcare and the environment : challenges

Oral healthcare has an environmental impact that is specific to the profession and is currently unsustainable. This impact results in unwanted and difficult-to-manage waste, carbon emissions and other environmental impacts that contribute to climate change. Contributions to this pollution come from the supply chain that provides the required materials and sundries, patient and staff commuting/travelling, direct patient care, the use and end-of-life management of restorative materials and single-use plastics (SUPs) such as personal protective equipment (PPE). This article explores these various contributors to pollution arising from oral healthcare. CPD/Clinical Relevance: The provision of oral healthcare has an environmental impact that requires consideration and action in order to become sustainable

Sustainable oral healthcare and the environment : mitigation strategies

Carbon emissions and single-use plastics (SUPs) are the main forms of environmental pollution relating to waste arising from oral healthcare. Ownership of this problem is shared with the whole supply chain, from manufacturing to distribution, procurement, clinical use and finally, waste management. Mitigation strategies focus on the individual stakeholders in the supply chain, including the provision of clinical care. Key to this, is establishing a baseline analysis of the nature and the size of the problem through Life Cycle Assessments (LCAs). Reduction of CO2 emissions, other associated environmental impacts, and plastic waste is considered through remote clinical consultations, recycling, patient education and the provision of high-quality care to achieve high impact environmentally sustainable outcomes

Wolf 1130: A Nearby Triple System Containing a Cool, Ultramassive White Dwarf

Following the discovery of the T8 subdwarf WISEJ200520.38+542433.9 (Wolf 1130C), with common proper motion to a binary (Wolf 1130AB) consisting of an M subdwarf and a white dwarf, we set out to learn more about the old binary in the system. We find that the A and B components of Wolf 1130 are tidally locked, which is revealed by the coherence of more than a year of V band photometry phase folded to the derived orbital period of 0.4967 days. Forty new high-resolution, near-infrared spectra obtained with the Immersion Grating Infrared Spectrometer (IGRINS) provide radial velocities and a projected rotational velocity (v sin i) of 14.7 +/- 0.7 km/s for the M subdwarf. In tandem with a Gaia parallax-derived radius and verified tidal-locking, we calculate an inclination of i=29 +/- 2 degrees. From the single-lined orbital solution and the inclination we derive an absolute mass for the unseen primary (1.24+0.19-0.15 Msun). Its non-detection between 0.2 and 2.5 microns implies that it is an old (>3.7 Gyr) and cool (Teff<7000K) ONe white dwarf. This is the first ultramassive white dwarf within 25pc. The evolution of Wolf 1130AB into a cataclysmic variable is inevitable, making it a potential Type Ia supernova progenitor. The formation of a triple system with a primary mass >100 times the tertiary mass and the survival of the system through the common-envelope phase, where ~80% of the system mass was lost, is remarkable. Our analysis of Wolf 1130 allows us to infer its formation and evolutionary history, which has unique implications for understanding low-mass star and brown dwarf formation around intermediate mass stars.Comment: 37 pages, 9 Figures, 5 Table

Evidence for variation in the effective population size of animal mitochondrial DNA

Background: It has recently been shown that levels of diversity in mitochondrial DNA are remarkably constant across animals of diverse census population sizes and ecologies, which has led to the suggestion that the effective population of mitochondrial DNA may be relatively constant. Results: Here we present several lines of evidence that suggest, to the contrary, that the effective population size of mtDNA does vary, and that the variation can be substantial. First, we show that levels of mitochondrial and nuclear diversity are correlated within all groups of animals we surveyed. Second, we show that the effectiveness of selection on non-synonymous mutations, as measured by the ratio of the numbers of non-synonymous and synonymous polymorphisms, is negatively correlated to levels of mitochondrial diversity. Finally, we estimate the effective population size of mitochondrial DNA in selected mammalian groups and show that it varies by at least an order of magnitude. Conclusions: We conclude that there is variation in the effective population size of mitochondria. Furthermore we suggest that the relative constancy of DNA diversity may be due to a negative correlation between the effective population size and the mutation rate per generation

Post-Disaster Housing Reconstruction in Sri Lanka: What Methodology?

Research methodology is the procedural framework within which the research is conducted. This includes the overall approach to a problem that could be put into practice in a research process, from the theoretical underpinning to the collection and analysis of data. Choice of methodology depends on the primary drivers: topic to be researched and the specific research questions. Hence, methodological perspectives of managing stakeholder expectations of PDHR context are composed of research philosophies, research strategy, research design, and research techniques. This research belonged to social constructivism or interpretivism within a philosophical continuum. The nature of the study was more toward subjectivism where human behavior favored voluntary stance. Ontological, methodological, epistemological, and axiological positioning carried the characteristics of idealism, ideographic, anti-positivism, and value laden, respectively. Data collection comprises two phases, preliminary and secondary. Exploratory interviews with construction experts in the United Kingdom and Sri Lanka were carried out to refine the interview questions and identify the case studies. Case study interviews during the secondary phase took place in Sri Lanka. Data collected at the preliminary stage were used to assess the attributes of power, legitimacy/proximity, and urgency of stakeholders to the project using Stakeholder Circle™ software. Moreover, the data collected at secondary phase via case studies will be analyzed with NVivo 8. This article aims to discuss these methodological underpinnings in detail applied in a post-disaster housing reconstruction context in Sri Lanka

Interaction of Alu Polymorphisms and Novel Measures of Discrimination in Association with Blood Pressure in African Americans Living in Tallahassee

African Americans are 40% more likely to be afflicted with hypertension in comparison to non-Hispanic, white Americans, resulting in a 30% higher instance of mortality due to cardiovascular disease. There is debate about the relative contributions of genetic and sociocultural risk factors to the racial disparity in hypertension. We assayed three Alu insertion polymorphisms located in the angiotensin-1-converting enzyme (ACE), tissue plasminogen activator (PLAT), and with no-lysine kinase 1 (WNK1) genes. We also estimated West African genetic ancestry and developed novel measures of perceived discrimination to create a biocultural model of blood pressure among African- American adults in Tallahassee, FL (n=158). When tested separately, the ACE Alu non-insertion allele was significantly associated with higher systolic and diastolic blood pressure. In multiple regression analyses, West African genetic ancestry was not associated with blood pressure and reduced the strength of all blood pressure models tested. A gene x environment interaction was identified between the ACE Alu genotype and a new measure of unfair treatment that includes experiences by individuals close to the study participant. Inclusion of the WNK1 Alu genotype further improved this model of blood pressure variation. Our results suggest an association of the ACE and WNK1 genotypes with blood pressure that is consistent with their proposed gene functions. Perceived unfair treatment (to others) shows a threshold effect where an increase in blood pressure is demonstrated at higher values. The interaction between the ACE genotype and unfair treatment highlights the benefits of including both genetic and cultural data to investigate complex disease