Alcohol Abstinence or Harm-Reduction? Parental Messages for College-Bound Light Drinkers

Parental communications about alcohol can have a significant impact on college students’ alcohol use; however, it is unclear what types of communication may be most beneficial for reducing alcohol risk, particularly among students who have already initiated alcohol use. The present research examines differences in alcohol use and employment of drinking protective behavioral strategies between pre-college matriculation high school seniors receiving predominantly abstinence parent messaging and students primarily receiving harm-reduction parent messaging. Students who identified as light drinkers were recruited during their last month in high school and completed an online assessment of alcohol use and parent alcohol communication. Analyses revealed that, in comparison to light drinkers who primarily received harm-reduction messaging from parents, light drinkers who received more abstinence messaging reported less frequent alcohol use, lower peak alcohol consumption, and greater use of protective drinking strategies aimed at changing the way they drank and avoiding serious hazards associated with drinking. Findings from this study underscore the utility of messages related to abstinence even for parents aware that their children have had previous experiences with alcohol and highlights the need for longitudinal research assessing additional mechanisms associated with message efficacy among light, moderate and heavy drinking students transitioning to college

El Marco de Poder, Amenaza y Significado: un sistema conceptual no diagnóstico alternativo

Este artículo resume los resultados recientemente publicados de un proyecto de investigación cuyo objeto es desarrollar un sistema conceptual que incorpore factores sociales, psicológicos y biológicos como alternativa al diagnóstico psiquiátrico funcional. Se describen brevemente los principios que subyacen al Marco de Poder, Amenaza y Significado junto con sus principales características y las diferencias respecto a los enfoques diagnósticos. Entre estos principios se incluye el supuesto de que lo que pueden llamarse “síntomas psiquiátricos” son respuestas comprensibles a entornos con frecuencia muy adversos y que estas respuestas, tanto evolutivas como influidas socialmente, cumplen funciones protectoras y ponen de manifiesto la capacidad humana de dotar de significado a las experiencias, así como la agencialidad. Describimos cómo interactúan los elementos del Marco de Poder, Amenaza y Significado para hacer explícitos los nexos entre las amenazas ambientales y las respuestas a dichas amenazas, y para delinear algunos Patrones Generales Provisionales probabilísticos –agrupados por su significado personal, social y cultural–, que describen lo que las personas hacen, no los “trastornos” que “tienen”. Concluimos esbozando algunas implicaciones del Marco para la construcción de narrativas y pensar el sufrimiento en las diferentes culturas

Recent developments in adjunct therapies for type 1 diabetes

Introduction: There have been many recent advances in the treatment of type 1 diabetes (T1D) including in insulin formulations, continuous glucose monitoring (CGM) technology and automated insulin delivery. However, long-term optimal glycemic control is still only achieved in a minority. Areas covered: Adjunct therapy – the use of therapeutic agents other than insulin – is one strategy aimed at improving outcomes. An ideal adjunct agent would improve glycemic control, reduce weight (or weight gain), reduce insulin requirement and prevent complications (e.g. cardiorenal) without increasing hypoglycemia. The amylin analogue pramlintide has been licensed in the USA, while the sodium glucose co-transporter-2 inhibitor (SGLT2i) dapagliflozin, was briefly (2019 − 2021) licensed for type 1 diabetes in Europe and the UK. However, other agents from the type 2 diabetes (T2D) arena including metformin, other SGLT2is, glucagon-like peptide-1 receptor agonists (GLP-1RA) and dipeptidyl peptidase-IV (DPP-4) inhibitors have been investigated. Expert opinion: As evidence emerges for cardiorenal protection by SGLT2is and GLP-1RAs in T2D, it has become increasingly important to know whether people with T1D can also benefit. Here, we review recent trials of adjunct agents in T1D and discuss the efficacy and safety of these agents (alone and in combination) in an era in which continuous glucose monitoring is becoming standard of care

Mass transfer in eccentric binaries: the new Oil-on-Water SPH technique

To measure the onset of mass transfer in eccentric binaries we have developed a two-phase SPH technique. Mass transfer is important in the evolution of close binaries, and a key issue is to determine the separation at which mass transfer begins. The circular case is well understood and can be treated through the use of the Roche formalism. To treat the eccentric case we use a newly-developed two phase system. The body of the donor star is made up from high-mass "water" particles, whilst the atmosphere is modelled with low-mass "oil" particles. Both sets of particles take part fully in SPH interactions. To test the technique we model circular mass-transfer binaries containing a 0.6 Msun donor star and a 1 Msun white dwarf; such binaries are thought to form cataclysmic variable (CV) systems. We find that we can reproduce a reasonable CV mass-transfer rate, and that our extended atmosphere gives a separation that is too large by aproximately 16%, although its pressure scale height is considerably exaggerated. We use the technique to measure the semi-major axis required for the onset of mass transfer in binaries with a mass ratio of q=0.6 and a range of eccentricities. Comparing to the value obtained by considering the instantaneous Roche lobe at pericentre we find that the radius of the star required for mass transfer to begin decreases systematically with increasing eccentricity.Comment: 9 pages, 8 figures, accepted by MNRA

Tracking Violent Crime with Ambulance Data: How Much Crime Goes Uncounted?

Abstract Research Question What proportion of ambulance records documenting injuries caused by criminal violence is included in police records for violent crimes occurring in the same area at the same dates and times as incidents found in ambulance records? Data We analysed subsets of three datasets during matched time periods: West Midlands Ambulance Service records of all 36,639 incidents of violent injuries from January 2012 to March 2017; 132,317 West Midlands Police records of violent crimes from January 2012 to December 2015; and 9083 records of treatment of violent injuries as recorded in hospital Emergency Department (ED) records covering September 2013 to March 2016. Methods We compared all incidents in the ambulance dataset and ED data to corresponding locations and times in incidents recorded in police datasets. Findings Approximately 90% of cases in the ambulance dataset did not have a corresponding case in the police dataset. The proportion was even lower in the Emergency Department dataset, where less than 5% of cases were successfully matched to a police record. These data suggest that adding the medical data to the police data could add 15 to 20% more violent offences to the totals recorded by the police. Conclusions Tracking identified ambulance data can add substantial numbers of serious violent crimes, over and above those reported to the police. These added cases can increase the targeting of police and public health resources to prevent harm against victims, at places, and by offenders at highest risk of serious violence. </jats:sec

Partnerships between deaf people and hearing dogs (PEDRO) : Effectiveness and Cost-Effectiveness of Receiving a Hearing Dog on Mental Well-Being and Health in People With Hearing Loss: Protocol for a Randomized Controlled Trial

Background People with hearing loss, particularly those who lose their hearing in adulthood, are at increased risk of social isolation, mental health difficulties, unemployment, loss of independence, risk of accidents, and impaired quality of life. In the United Kingdom (UK), a single third sector organisation provides hearing dogs, a specific type of assistance dog trained to provide sound support to people with hearing loss. These dogs may also deliver numerous psychosocial benefits to recipients. This has not previously been fully investigated. Objective To evaluate the impact of a hearing dog partnership on the lives of individuals with severe or profound hearing loss. Methods and Analysis A two-arm, randomised controlled trial conducted within the UK, with 162 hearing dog applicants, aged 18 years and over. Participants will be randomised 1:1 using a matched-pairs design to receive a hearing dog sooner than usual (intervention arm – Arm B) or to receive a hearing dog within the usual timeframe (comparator arm – Arm A). In the effectiveness analysis, the primary outcome is a comparison of mental wellbeing six-months after Arm B have received a hearing dog (Arm A: not yet received hearing dog), measured using the Short Warwick Edinburgh Mental Wellbeing Scale. Secondary outcome measures include the PHQ-9, GAD-7 and WSAS. An economic evaluation will assess cost-effectiveness including health-related quality-adjusted life years using the EQ-5D-5L and social-care-related-quality-adjusted life-years. Participants will be followed up for up to two years. A nested qualitative study will investigate the impacts of having a hearing dog and how these impacts come about. Results The study was funded by the National Institute for Health Research’s School for Social Care Research. Recruitment commenced in March 2017 and is now complete. 165 participants were randomised. Data collection will continue until January 2020. Results will be published in peer-reviewed journals and at conferences. A summary of the findings will be made available to participants. Ethical approval was received from the University of York’s Department of Social Policy and Social Work Research Ethics Committee (reference SPSW/S/17/1). Conclusions The findings from this study will provide, for the first time, strong and reliable evidence on the impact of having a hearing dog on people’s lives in terms of their quality of life, well-being and mental health. Trial registration The trial has been retrospectively registered International Standard Randomised Controlled Trial Number (ISRCTN) 36452009; https://doi.org/10.1186/ISRCTN36452009. Trial status: Ongoing

Parents and GPs’ understandings and beliefs about food allergy testing in children with eczema:qualitative interview study within the Trial of Eczema allergy Screening Tests (TEST) feasibility trial

Aim To explore parent and general practitioner (GP) understanding and beliefs about food allergy testing for children with eczema.Design and setting Qualitative interview study in UK primary care within the Trial of Eczema allergy Screening Tests feasibility trial.Participants Semi-structured interviews with parents of children with eczema taking part in the feasibility study and GPs at practices hosting the study.Results 21 parents and 11 GPs were interviewed. Parents discussed a range of potential causes for eczema, including a role for food allergy. They believed allergy testing to be beneficial as it could potentially identify a cure or help reduce symptoms and they found negative tests reassuring, suggesting to them that no dietary changes were needed. GPs reported limited experience and uncertainty regarding food allergy in children with eczema. While some GPs believed referral for allergy testing could be appropriate, most were unclear about its utility. They thought it should be reserved for children with severe eczema or complex problems but wanted more information to advise parents and help guide decision making.Conclusions Parents’ motivations for allergy testing are driven by the desire to improve their child’s condition and exclude food allergy as a possible cause of symptoms. GPs are uncertain about the role of allergy testing and want more information about its usefulness to support parents and help inform decision making.Trial registration number ISRCTN15397185

How many came home? Evaluating ex‐situ conservation of green turtles in the Cayman Islands

Ex-situ management is an important conservation tool that allows the preservation of biological diversity outside natural habitats while supporting survival in the wild. Captive breeding followed by reintroduction is a possible approach for endangered species conservation and preservation of genetic variability. The Cayman Turtle Centre Ltd was established in 1968 to market green turtle (Chelonia mydas) meat and other products and replenish wild populations, thought to be locally extirpated, through captive breeding. We evaluated the effects of this reintroduction program using molecular markers (13 microsatellites, 800bp D-loop and STR mtDNA sequences) from captive breeders (N=257) and wild nesting females (N=57) (sampling period: 2013-2015). We divided the captive breeders into three groups: founders (from the original stock), and then two subdivisions of F1 individuals corresponding to two different management strategies, cohort 1995 ("C1995)" and multicohort F1 ("MCF1"). Loss of genetic variability and increased relatedness was observed in the captive stock over time. We found no significant differences in diversity among captive and wild groups, and similar or higher levels of haplotype variability when compared to other natural populations. Using parentage and sibship assignment, we determined that 90% of the wild individuals were related to the captive stock. Our results suggest a strong impact of the reintroduction program on the present recovery of the wild green turtle population nesting in the Cayman Islands. Moreover, genetic relatedness analyses of captive populations are necessary to improve future management actions to maintain genetic diversity in the long term and avoid inbreeding depression