Attachment-based family therapy for adolescent substance use: A move to the level of systems

This paper provides an account of the theoretical basis of a family-based intervention called Behaviour Exchange and Systems Therapy (BEST). The model described here has also been applied to adolescents with substance abuse and other mental health problems such as depression and anxiety disorders in both children and adolescents. Evaluative studies of the model have been published including randomised clinical trials as well as qualitative analyses. The current paper discusses a theory of the family system as a discourse and represents an integration of aspects of attachment, psychoanalytic, and systems theories. Key concepts elaborated are the attachment-family system, the family as a single discourse, the use of segregation as a defense in relation to trauma and loss and its manifestation in a family narrative, and the role of the family secure base in affect regulation. The paper also briefly describes specific treatment techniques that are derived from the theoretical model. Our approach has wide application as a discourse focused treatment for children and adolescents using a family systems approach. Future work requires the comparison of this model to similar attachment-based models of intervention for children and families, further development and validation of measures able to be used for whole families in a clinical setting, and further empirical demonstration of treatment efficacy in a variety of clinical settings

Increasing the spatial resolution of agricultural land cover maps using a Hopfield neural network

Land cover class composition of remotely sensed image pixels can be estimated using soft classification techniques increasingly available in many GIS packages. However, their output provides no indication of how such classes are distributed spatially within the instantaneous field of view represented by the pixel. Techniques that attempt to provide an improved spatial representation of land cover have been developed, but not tested on the difficult task of mapping from real satellite imagery. The authors investigated the use of a Hopfield neural network technique to map the spatial distributions of classes reliably using information of pixel composition determined from soft classification previously. The approach involved designing the energy function to produce a ‘best guess’ prediction of the spatial distribution of class components in each pixel. In previous studies, the authors described the application of the technique to target identification, pattern prediction and land cover mapping at the sub-pixel scale, but only for simulated imagery.We now show how the approach can be applied to Landsat Thematic Mapper (TM) agriculture imagery to derive accurate estimates of land cover and reduce the uncertainty inherent in such imagery. The technique was applied to Landsat TM imagery of small-scale agriculture in Greece and largescale agriculture near Leicester, UK. The resultant maps provided an accurate and improved representation of the land covers studied, with RMS errors for the Landsat imagery of the order of 0.1 in the new fine resolution map recorded. The results showed that the neural network represents a simple efficient tool formapping land cover from operational satellite sensor imagery and can deliver requisite results and improvements over traditional techniques for the GIS analysis of practical remotely sensed imagery at the sub pixel scale

Depression and parenting: The need for improved intervention models

The impact of maternal depression on parenting is well established and there is a clear interaction between maternal depression and parenting that is predictive of child outcomes. The research on paternal depression is more limited but suggests the father’s mental health may be an independent risk factor for both parenting and child outcomes. There is insufficient evidence that treatment of depression alone – be it through pharmacological or psychological interventions – is able to substantially reduce the impact of depression on child outcomes. The evidence of interventions aimed at parenting and/or child outcomes in the context of depression is limited and the findings that are available are mixed

Thiamine deficiency and beriberi heart disease

No Abstract

Gender differences in trajectories of depressive symptoms across childhood and adolescence: A multi-group growth mixture model

Background This study sought to identify depression trajectories across childhood and to model a range of child and family predictors of whether a child may be on an increasing trajectory towards depressive disorder in adolescence. Methods Multi-group growth mixture modelling (MGMM) was used on a sample of 4983 children from the Longitudinal Study of Australia Children (LSAC). Depressive symptoms of these children were assessed over 10-years with six time-points, administered every second year commencing at 4 years via the parent report version of the Strength and Difficulties Questionnaire. Predictors of class membership were also examined. Results Four trajectories were found to be the best fitting model characterising low-stable (75%); decreasing (11%); increasing (9%); high and rising (6%) groups. Females were more likely to be in a trajectory of increasing depressive symptoms between 4 and 14 years of age than males. Reactive temperament and maternal depression at four and six years of age were consistent predictors of increasing and high trajectories while persistent temperament acts as a protective factor for females. Limitations The findings should be interpreted in the light of limitations due to common-method variance and the absence of diagnostic indicators of depressive disorder. Conclusions We conclude that there are gender differences in patterns of depressive symptoms from childhood to adolescence and meaningful predictors of these early developmental trajectories. Preventative interventions in childhood targeting parents with depression and children with temperamental difficulties may be indicated

Parenting stress, maternal depression and child mental health in a Melbourne cohort before and during the COVID‐19 pandemic

Aim This paper aims to examine the maternal and child mental health and parenting outcomes in the context of COVID-19 pandemic conditions using a sample from Melbourne, Australia – a city exposed to one of the longest lockdowns world-wide in response to the pandemic. Methods This study utilises observational data from a prospective, pregnancy cohort, Mercy Pregnancy Emotional Wellbeing Study and includes 468 women and their children followed up in Melbourne to 3–4 years postpartum pre-COVID pandemic and compared to those followed up during the COVID-19 pandemic. Results When compared to mothers followed up at 3–4 years postpartum pre-pandemic, those followed up during the COVID-19 pandemic showed higher depressive symptoms with a steep incline in their symptom trajectory (EMMdifference = 1.72, Bonferroni-corrected P < 0.01, d = 0.35) and had a three times higher risk of scoring 13 or above on the EPDS (aRR = 3.22, Bonferroni-corrected P < 0.01). Although this increase was not associated with the variation in the duration of exposure to pandemic conditions, the steep increase in depressive symptoms was more pronounced in those with pre-existing depressive disorders. There was no difference in parenting stress or adjusted childhood mental health symptoms or disorder. Conclusions Our findings highlight the vulnerability of those with pre-existing clinical mental health disorders and the need for adequate clinical care for this vulnerable group. Equally, our study indicates the possibility that parenting and early childhood mental health outcomes, at least in the short term, may be resilient

Characterising variations in the salinity of deep groundwater systems: A case study from Great Britain (GB)

Study region The study region is Great Britain (GB), a small non-continental island landmass in North West Europe Study focus Data for Total Dissolved Solids (TDS) from groundwater samples can be used to characterise regional-scale variations in the quality of deep groundwater systems. Combined with information about typical well-depths, TDS data can be used to identify the presence of currently undeveloped fresh or brackish groundwater at depth that may require protection. This study considers the distribution of TDS with depth relative to sea level in the main GB aquifers and selected other key hydrogeological units, and demonstrates how useful insights can be obtained from data-led analyses of depth variations in groundwater chemistry if the regional context of hydrogeological systems is taken into account. New hydrogeological insights In GB, TDS varies over about five orders of magnitude, up to about 330,000 mg/L, with a general increase in mineralisation with depth. Overall, there is a transition from fresh 10,000 mg/L groundwater at about 700 m. Given that the 95 %tile depth of water wells is about 200 m, it is evident that there is currently undeveloped fresh groundwater at depth across large parts of the study area that may require protection, although it is inferred that TDS is not the only factor limiting exploitation and use of these deeper resources. As in this study, previous data-led analyses of fresh groundwater at depth have typically analysed TDS as depth below surface. However, if TDS data is analysed relative to sea level and in the context of regional hydrogeological information or models, additional insights can be gained on the distribution and controls on fresh groundwater at depth. Projecting TDS data into a 3D hydrogeological model of the study area shows that fresh groundwater at depth exhibits spatial coherence and is generally associated with relatively dee

Modelling the groundwater nitrate legacy

This report details the findings of a project jointly funded by the British Geological Survey (BGS)and Defra through the Environment Agency. The overall aim of the work was to investigate the use of new models to inform decision-making on nitrate pollution in groundwater and the potential for incorporating unsaturated zone processes into the model currently used by the Environment Agency to delineate Nitrate Vulnerable Zones (NVZs). The potential application as supporting evidence for the Water Framework Directive has also been considered as nitrate pollution of groundwater remains the most significant reason for failure of WFD environmental objectives across England. The background to the nitrate legacy in groundwater and to the approaches to NVZ designation is described in Stuart et al. (2016). A series of developments to the BGS Nitrate Time Bomb (NTB) model have been made to improve a number of areas and approaches used in the first version of the model. The improvements included a spatially and temporally distributed nitrate input function, improved unsaturated zone thickness estimation, travel time attribution using a 1:250,000 geological map, estimating nitrate velocity in the unsaturated zone using groundwater recharge and aquifer properties, and introducing nitrate transport processes in low permeability superficial deposits and the saturated zones. These now allow the model to be applied at sub national scale. Using the improved model we have also made the first estimate of the mass of nitrate stored within the unsaturated zone and how this will change over time to improve UK nitrate budget estimates. The new version of the BGS NTB approach was applied in three case studies at different scales which compared its outcomes to the results from other modelling to demonstrate that the model can be benchmarked against the other nitrate modelling approaches: • For a basin-scale model of the Thames Chalk (Howden et al., 2010 & 2011). The NTB model gave comparable results to the original study back to 1925 provided that the same nitrate input function was used. Both models failed to predict nitrate concentrations in the Thames after the mid-1980s. • At the multi-borehole scale in the Permo-Triassic. A similar approach was used to the BGS model in the Eden Valley. This replicated the existing model for the area used by the Environment Agency both in terms of trend assessment and in the lack of dilution available within the aquifer block for blending purposes. • At the single borehole scale in the Chalk of the South Downs. The existing Environment and National Park model constructed by AMEC treated the unsaturated zone very similarly to the NTB model. This model provided a good fit to observed concentrations and confirmed the importance of estimating unsaturated zone delays. The assessment of modelled travel time from different areas of the catchment clearly illustrated the arable areas that would give a relatively rapid respond to changes in nitrate management. To illustrate the potential application of the BGS NTB model to support the Environment Agency’s NVZ designation methodology, areas of England were identified where unsaturated zone lags may be significant and where there is uncertainty in the NVZ designation. A major advantage of the BGS NTB model is that it covers the whole of England (and Wales) in a consistent way. A national overview of areas of designation uncertainty identified large areas of England, in particular the chalk outcrop of southern and eastern England. These were compared to areas with significant unsaturated zone travel time indicating where travel time may be contributing to designation uncertainty. The results suggest that the model may be useful both for identifying currently impacted groundwater which reflects legacy fertilizer application and also where additional designation could be needed as impacts have not yet emerged. Application of the model to support implementation of the WFD has also been considered and whilst no quantitative analysis has yet been carried out there are a number of ways that the model could be of significant benefit. For example, the model could be used to estimate when trend reversal would be expected to occur as a result of measures (at a specific location or across a groundwater body) and the time required to achieve good chemical status (alternative objective setting). A further application could be for scenario testing such as evaluating the effects of different land use/management measures as part of cost benefit analysis or considering the long term impacts of climate change through changing fertiliser use and/or recharge

Trajectories of early childhood developmental skills and early adolescent psychotic experiences: Findings from the ALSPAC UK Birth Cohort

Objective: The aim of this study was to use prospective data from the Avon Longitudinal Study of Parents and Children (ALSPAC) to examine association between trajectories of early childhood developmental skills and psychotic experiences (PEs) in early adolescence. Method: This study examined data from n = 6790 children from the ALSPAC cohort who participated in a semi-structured interview to assess PEs at age 12. Child development was measured using parental report at 6, 18, 30, and 42 months of age using a questionnaire of items adapted from the Denver Developmental Screening Test - II. Latent class growth analysis was used to generate trajectories over time for measures of fine and gross motor development, social, and communication skills. Logistic regression was used to investigate associations between developmental trajectories in each of these early developmental domains and PEs at age 12. Results: The results provided evidence that decline rather than enduringly poor social (adjusted OR = 1.28, 95% CI = 1.10-1.92, p = 0.044) and communication skills (adjusted OR = 1.12, 95% CI = 1.03-1.22, p = 0.010) is predictive of suspected or definite PEs in early adolescence, than those with stable and/or improving skills. Motor skills did not display the same pattern of association; although gender specific effects provided evidence that only declining pattern of fine motor skills was associated with suspected and definite PEs in males compared to females (interaction OR = 1.47, 95% CI =1.09-1.97, p = 0.012). Conclusion: Findings suggest that decline rather than persistent impairment in social and communication skills were most predictive of PEs in early adolescence. Findings are discussed in terms of study's strengths, limitations, and clinical implications

Development and feasibility testing of a smart phone based attentive eating intervention

BACKGROUND: Attentive eating means eating devoid of distraction and increasing awareness and memory for food being consumed. Encouraging individuals to eat more attentively could help reduce calorie intake, as a strong evidence base suggests that memory and awareness of food being consumed substantially influence energy intake. METHODS: The development and feasibility testing of a smartphone based attentive eating intervention is reported. Informed by models of behavioral change, a smartphone application was developed. Feasibility was tested in twelve overweight and obese volunteers, sampled from university staff. Participants used the application during a four week trial and semi-structured interviews were conducted to assess acceptability and to identify barriers to usage. We also recorded adherence by downloading application usage data from participants' phones at the end of the trial. RESULTS: Adherence data indicated that participants used the application regularly. Participants also felt the application was easy to use and lost weight during the trial. Thematic analysis indicated that participants felt that the application raised their awareness of what they were eating. Analysis also indicated barriers to using a smartphone application to change dietary behavior. CONCLUSIONS: An attentive eating based intervention using smartphone technology is feasible and testing of its effectiveness for dietary change and weight loss is warranted