Shared geriatric mental health care in a rural community

Introduction: A pilot project in shared mental health care was initiated to explore opportunities to increase the capacity of the rural primary care system as a resource for older people with mental health needs. This was done within a framework for the delivery of best practices in geriatric mental health outreach. Methods: Shared-care strategies combining education and clinical consultation between mentor psychiatrists and family physicians were implemented and then evaluated after one year to identify key factors in the success of approaches to shared mental health care for older people in a rural setting. Results: Results provided new insights into shared care between primary care and specialty geriatric mental health services, rural geriatric mental health service delivery, developmental phases in service learning approaches, and building knowledge networks to promote continuing best practices. Conclusion: The results from the project's process evaluation have been integrated into the development of a permanent shared geriatric mental health care service for the rural setting. Preparation for an outcome evaluation that will focus on the impact on patient care has also been initiated

Fostering human health through ocean sustainability in the 21st century

This is the final version. Available on open access from Wiley via the DOI in this recordThe approach of the Decade of the Ocean for Sustainable Development (2021–2030) provides a time to reflect on what we know about the complex interactions between the seas, oceans, and human health and well‐being. In the past, these interactions have been seen primarily within a risk framework, for example, adverse impacts of extreme weather, chemical pollution and increasingly, climate change. However, new research is expanding our concept of the ‘health’ of the ‘Global Ocean’, with a broader recognition of its essential and beneficial contribution to the current and future health and well‐being of humans. The seas and coasts not only provide an essential source of food, opportunities for trade and access to sustainable energy, but also the chance for people to interact with high‐quality marine environments which can lead to improvements in mental and physical health and well‐being, particularly of socio‐economically deprived individuals. By going beyond this risk framework and a purely extractive anthropocentric point of view, we can capture the true benefits, value and importance of these resources. Articulating a vision of how humans might better interact with marine ecosystems in the future, is a key first step in identifying a range of policy and management actions that can deliver our goals of fostering health and well‐being through the establishment of more sustainable interconnections with the Global Ocean.European Union Horizon 2020Natural Environment Research Council (NERC)UKRI Global Challenges Research FundNational Institute for Health Research (NIHR

Coastal proximity and mental health among urban adults in England: The moderating effect of household income

This is the final version. Available on open access from Elsevier via the DOI in this recordAfter adjusting for covariates, self-reported general health in England is higher among populations living closer to the coast, and the association is strongest amongst more deprived groups. We explored whether similar findings were present for mental health using cross-sectional data for urban adults in the Health Survey for England (2008-2012, N ≥25,963). For urban adults, living ≤1 km from the coast, in comparison to >50 km, was associated with better mental health as measured by the GHQ12. Stratification by household income revealed this was only amongst the lowest-earning households, and extended to ≤5 km. Our findings support the contention that, for urban adults, coastal settings may help to reduce health inequalities in England.National Institute for Health Research (NIHR)European Union Horizon 202

Systematic review of the behavioural assessment of pain in cats

Objectives The objectives were to review systematically the range of assessment tools used in cats to detect the behavioural expression of pain and the evidence of their quality; and to examine behavioural metrics (considering both the sensory and affective domains) used to assess pain. Methods A search of PubMed and ScienceDirect, alongside articles known to the authors, from 2000 onwards, for papers in English was performed. This was followed by a manual search of the references within the primary data sources. Only peer-reviewed publications that provided information on the assessment tool used to evaluate the behavioural expression of pain in cats, in conscious animals (not anaesthetised cats), were included. Results No previous systematic reviews were identified. One hundred papers were included in the final assessment. Studies were primarily related to the assessment of pain in relation to surgical procedures, and no clear distinction was made concerning the onset of acute and chronic pain. Ten broad types of instrument to assess pain were identified, and generally the quality of evidence to support the use of the various instruments was poor. Only one specific instrument (UNESP-Botucatu scale) had published evidence of validity, reliability and sensitivity at the level of a randomised control trial, but with a positive rather than placebo control, and limited to its use in the ovariohysterectomy situation. The metrics used within the tools appeared to focus primarily on the sensory aspect of pain, with no study clearly discriminating between the sensory and affective components of pain. Conclusions and relevance Further studies are required to provide a higher quality of evidence for methods used to assess pain in cats. Furthermore, a consistent definition for acute and chronic pain is needed. Tools need to be validated that can detect pain in a range of conditions and by different evaluators (veterinary surgeons and owners), which consider both the sensory and emotional aspects of pain

Associations between pro-environmental behaviour and neighbourhood nature, nature visit frequency and nature appreciation: Evidence from a nationally representative survey in England

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From Theory-Inspired to Theory-Based Interventions: A Protocol for Developing and Testing a Methodology for Linking Behaviour Change Techniques to Theoretical Mechanisms of Action

BACKGROUND: Understanding links between behaviour change techniques (BCTs) and mechanisms of action (the processes through which they affect behaviour) helps inform the systematic development of behaviour change interventions. PURPOSE: This research aims to develop and test a methodology for linking BCTs to their mechanisms of action. METHODS: Study 1 (published explicit links): Hypothesised links between 93 BCTs (from the 93-item BCT taxonomy, BCTTv1) and mechanisms of action will be identified from published interventions and their frequency, explicitness and precision documented. Study 2 (expert-agreed explicit links): Behaviour change experts will identify links between 61 BCTs and 26 mechanisms of action in a formal consensus study. Study 3 (integrated matrix of explicit links): Agreement between studies 1 and 2 will be evaluated and a new group of experts will discuss discrepancies. An integrated matrix of BCT-mechanism of action links, annotated to indicate strength of evidence, will be generated. Study 4 (published implicit links): To determine whether groups of co-occurring BCTs can be linked to theories, we will identify groups of BCTs that are used together from the study 1 literature. A consensus exercise will be used to rate strength of links between groups of BCT and theories. CONCLUSIONS: A formal methodology for linking BCTs to their hypothesised mechanisms of action can contribute to the development and evaluation of behaviour change interventions. This research is a step towards developing a behaviour change 'ontology', specifying relations between BCTs, mechanisms of action, modes of delivery, populations, settings and types of behaviour

Classic and spatial shift-share analysis of state-level employment change in Brazil

This paper combines classic and spatial shift-share decompositions of 1981 to 2006 employment change across the 27 states of Brazil. The classic shift-share method shows higher employment growth rates for underdeveloped regions that are due to an advantageous industry-mix and also due to additional job creation, commonly referred to as the competitive effect. Alternative decompositions proposed in the literature do not change this broad conclusion. Further examination employing exploratory spatial data analysis (ESDA) shows spatial correlation of both the industry-mix and the competitive effects. Considering that until the 1960s economic activities were more concentrated in southern regions of Brazil than they are nowadays, these results support beta convergence theories but also find evidence of agglomeration effects. Additionally, a very simple spatial decomposition is proposed that accounts for the spatially-weighted growth of surrounding states. Favourable growth in northern and centre-western states is basically associated with those states’ strengths in potential spatial spillover effect and in spatial competitive effect

The effects of meteorological conditions and daylight on nature-based recreational physical activity in England

This is the final version. Available on open access from Elsevier via the DOI in this recordMeteorological conditions affect people’s outdoor physical activity. However, we know of no previous research into how these conditions affect physical activity in different types of natural environments – key settings for recreational physical activity, but ones which are particularly impacted by meteorological conditions. Using responses from four waves (2009–2013) of a survey of leisure visits to natural environments in England (n = 47,613), visit dates and locations were ascribed estimates of energy expenditure (MET-minutes) and assigned meteorological data. We explored relationships between MET-minutes in natural environments (in particular, parks, woodlands, inland waters, and coasts) and the hourly maxima of air temperature and wind speed, levels of rainfall, and daylight hours using generalised additive models. Overall, we found a positive linear relationship between MET-minutes and air temperature; a negative linear relationship with wind speed; no relation with categories of rainfall; and a positive, but non-linear relationship with daylight hours. These same trends were observed for park-based energy expenditure, but differed for visits to other natural environments: only daylight hours were related to energy expenditure at woodlands; wind speed and daylight hours affected energy expenditure at inland waters; and only air temperature was related to energy expenditure at coasts. Natural environments support recreational physical activity under a range of meteorological conditions. However, distinct conditions do differentially affect the amount of energy expenditure accumulated in a range of natural environments. The findings have implications for reducing commonly-reported meteorological barriers to both recreational physical activity and visiting natural environments for leisure, and begin to indicate how recreational energy expenditure in these environments could be affected by future climate change.National Institute for Health Research (NIHR)European Commissio

Hierarchic Superposition Revisited

Many applications of automated deduction require reasoning in first-order logic modulo background theories, in particular some form of integer arithmetic. A major unsolved research challenge is to design theorem provers that are "reasonably complete" even in the presence of free function symbols ranging into a background theory sort. The hierarchic superposition calculus of Bachmair, Ganzinger, and Waldmann already supports such symbols, but, as we demonstrate, not optimally. This paper aims to rectify the situation by introducing a novel form of clause abstraction, a core component in the hierarchic superposition calculus for transforming clauses into a form needed for internal operation. We argue for the benefits of the resulting calculus and provide two new completeness results: one for the fragment where all background-sorted terms are ground and another one for a special case of linear (integer or rational) arithmetic as a background theory