Antidepressant prescriptions and mental health nurses:An observational study in Dutch general practice from 2011 to 2015

Purpose: The purpose of this study was to investigate developments in antidepressant prescriptions by Dutch general practitioners, alongside the national introduction of mental health nurses. Antidepressant prescriptions are very common in general practice, but are often not in line with recommendations. The recent introduction of mental health nurses may have decreased antidepressant prescriptions, as general practitioners (GPs) have greater potential to offer psychological treatment as a first choice option instead of medication. Material and methods: Anonymised data from the medical records of general practices participating in the NIVEL Primary Care Database in 2011-2015 were analysed in an observational study. We used multilevel logistic regression analyses to determine whether total antidepressant prescriptions and antidepressants prescribed within one week of diagnosing anxiety or depression decreased in the period 2011-2015. We analysed whether changes in antidepressant prescriptions were associated with the employment or consultation of mental health nurses. Results: Antidepressants were prescribed in 30.3% of all anxiety or depression episodes; about half were prescribed within the first week. Antidepressants prescriptions for anxiety or depression increased slightly in the period 2011-2015. The employment of mental health nurses was not associated with a decreased number of prescriptions of antidepressants. Patients who had at least one mental health nurse consultation had fewer immediate prescriptions of antidepressants, but not fewer antidepressants in general. Conclusions: Antidepressant prescriptions are still common in general practice. So far, the introduction of mental health nurses has not decreased antidepressant prescriptions, but it may have a postponing effect

Is the `Finite Bias Anomaly' in planar GaAs-Superconductor junctons caused by point-contact like structures?

We correlate transmission electron microscope (TEM) pictures of superconducting In contacts to an AlGaAs/GaAs heterojunction with differential conductance spectroscopy performed on the same heterojunction. Metals deposited onto a (100) AlGaAs/GaAs heterostructure do not form planar contacts but, during thermal annealing, grow down into the heterostructure along crystallographic planes in pyramid-like `point contacts'. Random surface nucleation and growth gives rise to a different interface transmission for each superconducting point contact. Samples annealed for different times, and therefore having different contact geometry, show variations in $dI/dV$ characteristic of ballistic transport of Cooper pairs, wave interference between different point emitters, and different types of weak localization corrections to Giaever tunneling. We give a possible mechanism whereby the `finite bias anomaly' of Poirier et al. (Phys. Rev. Lett., {\bf 79}, 2105 (1997)), also observed in these samples, can arise by adding the conductance of independent superconducting point emitters in parallel

Proximity effects and Andreev reflection in mesoscopic SNS junction with perfect NS interfaces

Low temperature transport measurements on superconducting film - normal metal wire - superconducting film (SNS) junctions fabricated on the basis of 6 nm thick superconducting polycrystalline PtSi films are reported. The structures with the normal metal wires of two different lengths L=1.5 $\mu$m and L=6$\mu$m and the same widths W=0.3$\mu$m are studied. Zero bias resistance dip related to pair current proximity effect is observed for all junctions whereas the subharmonic energy gap structure originating from phase coherent multiple Andreev reflections have occurs only in the SNS junctions with short wires.Comment: ReVTex, 4 pages, 4 eps figures include

Two-dimensional array of diffusive SNS junctions with high-transparent interfaces

We report the first comparative study of the properties of two-dimensional arrays and single superconducting film - normal wire - superconducting film (SNS) junctions. The NS interfaces of our SNS junctions are really high transparent, for superconducting and normal metal parts are made from the same material (superconducting polycrystalline PtSi film). We have found that the two-dimensional arrays reveal some novel features: (i) the significant narrowing of the zero bias anomaly (ZBA) in comparison with single SNS junctions, (ii) the appearance of subharmonic energy gap structure (SGS), with up to n=16 (eV=\pm 2\Delta/n), with some numbers being lost, (iii) the transition from 2D logarithmic weak localization behavior to metallic one. Our experiments show that coherent phenomena governed by the Andreev reflection are not only maintained over the macroscopic scale but manifest novel pronounced effects as well. The behavior of the ZBA and SGS in 2D array of SNS junctions strongly suggests that the development of a novel theoretical approach is needed which would self-consistently take into account the distribution of the currents, the potentials, and the superconducting order parameter.Comment: RevTex, 5 pages, 5 figure

Theory of charge transport in diffusive normal metal / unconventional singlet superconductor contacts

We analyze the transport properties of contacts between unconventional superconductor and normal diffusive metal in the framework of the extended circuit theory. We obtain a general boundary condition for the Keldysh-Nambu Green's functions at the interface that is valid for arbitrary transparencies of the interface. This allows us to investigate the voltage-dependent conductance (conductance spectrum) of a diffusive normal metal (DN)/ unconventional singlet superconductor junction in both ballistic and diffusive cases. For d-wave superconductor, we calculate conductance spectra numerically for different orientations of the junctions, resistances, Thouless energies in DN, and transparencies of the interface. We demonstrate that conductance spectra exhibit a variety of features including a $V$-shaped gap-like structure, zero bias conductance peak (ZBCP) and zero bias conductance dip (ZBCD). We show that two distinct mechanisms: (i) coherent Andreev reflection (CAR) in DN and (ii) formation of midgap Andreev bound state (MABS) at the interface of d-wave superconductors, are responsible for ZBCP, their relative importance being dependent on the angle $\alpha$ between the interface normal and the crystal axis of d-wave superconductors. For $\alpha=0$, the ZBCP is due to CAR in the junctions of low transparency with small Thouless energies, this is similar to the case of diffusive normal metal / insulator /s-wave superconductor junctions. With increase of $\alpha$ from zero to $\pi/4$, the MABS contribution to ZBCP becomes more prominent and the effect of CAR is gradually suppressed. Such complex spectral features shall be observable in conductance spectra of realistic high-$T_c$ junctions at very low temperature

Spin-polarized proximity effect in superconducting junctions

We study spin dependent phonomena in superconducting junctions in both ballistic and diffusive regimes. For ballistic junctions we study both ferromagnet / $s$- and d-wave superconductor junctions and two dimensional electron gas / s-wave superconductor junctions with Rashba spin-orbit coupling. It is shown that the exchange field alway suppresses the conductance while the Rashba spin-orbit coupling can enhance it. In the latter part of the article we study the diffusive ferromagnet / insulator / $s$- and d-wave superconductor junctions, where the proximity effect can be enhanced by the exchange field in contrast to common belief. It is shown that the resonant proximity effect originating from the exchange field strongly influences the tunneling conductance and density of states.Comment: 14 pages, 7 figures, submitted to Comptes Rendus de l'Acadeacute;mie des Sciences (Comptes Rendus Physique) Special Issue " Magnetism and Superconductivity Coexistence". Figures 4-7 are modified in v

The development of spontaneous facial responses to others’ emotions in infancy. An EMG study

Viewing facial expressions often evokes facial responses in the observer. These spontaneous facial reactions (SFRs) are believed to play an important role for social interactions. However, their developmental trajectory and the underlying neurocognitive mechanisms are still little understood. In the current study, 4- and 7-month old infants were presented with facial expressions of happiness, anger, and fear. Electromyography (EMG) was used to measure activation in muscles relevant for forming these expressions: zygomaticus major (smiling), corrugator supercilii (frowning), and frontalis (forehead raising). The results indicated no selective activation of the facial muscles for the expressions in 4-month-old infants. For 7-month-old infants, evidence for selective facial reactions was found especially for happy faces (leading to increased zygomaticus major activation) and fearful faces (leading to increased frontalis activation), while angry faces did not show a clear differential response. This suggests that emotional SFRs may be the result of complex neurocognitive mechanisms which lead to partial mimicry but are also likely to be influenced by evaluative processes. Such mechanisms seem to undergo important developments at least until the second half of the first year of life

Vascular endothelial growth factor as a non-invasive marker of pulmonary vascular remodeling in patients with bronchitis-type of COPD

BACKGROUND: Several studies have indicated that one of the most potent mediators involved in pulmonary vascular remodeling is vascular endothelial growth factor (VEGF). This study was designed to determine whether airway VEGF level reflects pulmonary vascular remodeling in patients with bronchitis-type of COPD. METHODS: VEGF levels in induced sputum were examined in 23 control subjects (12 non-smokers and 11 ex-smokers) and 29 patients with bronchitis-type of COPD. All bronchitis-type patients performed exercise testing with right heart catheterization. RESULTS: The mean pulmonary arterial pressure (mPAP) and pulmonary vascular resistance (PVR) after exercise were markedly increased in all bronchitis-type patients. However, both parameters after exercise with breathing of oxygen was significantly lower than in those with breathing of room air. To attenuate the effect of hypoxia-induced pulmonary vasoconstriction during exercise, we used the change in mPAP or PVR during exercise with breathing of oxygen as a parameter of pulmonary vascular remodeling. Change in mPAP was significantly correlated with VEGF level in induced sputum from patients with chronic bronchitis (r = 0.73, p = 0.0001). Moreover, change in PVR was also correlated with VEGF level in those patients (r = 0.57, p = 0.003). CONCLUSION: A close correlation between magnitude of pulmonary hypertension with exercise and VEGF level in bronchitis-type patients could be observed. Therefore, these findings suggest the possibility that VEGF level in induced sputum is a non-invasive marker of pulmonary vascular remodeling in patients with bronchitis-type of COPD

Experiential peer support and its effects on desistance from delinquent behavior: protocol paper for a systematic realist literature review.

Background Experiential peers are increasingly involved in the development and delivery of interventions for individuals who are engaged in delinquent behavior. Experiential peer support, which is the provision of support to an individual engaged in delinquent behavior by someone who has previously also practiced such behavior, is one such application. Little is known, however, about its effects on desistance, or the mechanisms that explain these effects. On the basis of theoretical papers, program descriptions, and interviews with experts, we developed an initial program theory. We propose seven mechanisms that might play a role in the (potential) effects of support by experiential peers: (1) empathy and acceptance, (2) social learning, (3) social bonding, (4) social control, (5) narrative and identity formation, (6) hope and perspective, and (7) translation and connection. In addition, in this protocol paper, we describe the methods of a systematic realist literature review that will be conducted in order to investigate the evidence base for this program theory. Methods The study described in this protocol paper is a realist review, which is a suitable approach to study complex interventions and fits the explanatory purpose of the study. We outline the steps to be taken for the systematic realist review, including the selection and assessment of studies and the methods for synthesizing the findings. Discussion Investigating the effects and the underlying mechanisms of support by experiential peers for individuals with delinquent behavior is relevant because the forensic setting has some unique features, and the involvement of service users might create even more tension than in other settings due to stigma and perceived risks. The findings that will be reported in the realist review will contribute to the knowledge of the effects of support by experiential peers and will provide insight into which aspects remain to be studied. It might also provide formal care institutions with guidance on whether to involve experiential peers in the delivery of their services and the conditions under which these interventions are likely to lead to positive results

Event-based prospective memory performance in autism spectrum disorder

The purpose of the present study was to investigate event-based prospective memory performance in individuals with autism spectrum disorder and to explore possible relations between laboratory-based prospective memory performance and everyday performance. Nineteen children and adolescents with autism spectrum disorder and 19 matched neurotypical controls participated. The laboratory-based prospective memory test was embedded in a visuo-spatial working memory test and required participants to remember to respond to a cue-event. Everyday planning performance was assessed with proxy ratings. Although parents of the autism group rated their children’s everyday performance as significantly poorer than controls’ parents, no group differences were found in event-based prospective memory. Nevertheless, individual differences in laboratory-based and everyday performances were related. Clinical implications of these findings are discussed