61 research outputs found
Use of the Strengths & Difficulties Questionnaire to identify treatment needs in looked after children referred to CAMHS
© The Author(s) 2019Background: In England and Wales, the Strengths & Difficulties Questionnaire (SDQ) is used to assess and monitor looked after childrenâs (LAC) mental health; and some targeted CAMHS teams use it to decide who can access services. However, the ability of the single-informant SDQ to identify LAC who need mental health treatment is insufficiently understood. Methods: 144 LAC referrals to a Targeted CAMHS Team were screened as part of a larger study. To establish how well the SDQ identified children who required treatment, Total Difficulties Scores (TDS) from single-informant SDQs submitted at referral were compared to treatment recommendations following routine CAMHS assessment in a real-world setting. To explain the results, clinicians (n=9) from the team were interviewed and key themes identified using Thematic Analysis. Results: Optimal accuracy calculations for SDQs completed by carers (TDS=17, sensitivity .67, specificity .57), teachers (TDS=17, sensitivity .79, specificity .71) and young people (TDS=14, sensitivity.79, specificity .42) compared to the outcome of routine CAMHS assessments indicated that the number of children whose treatment needs were not identified by their SDQ score may be unacceptably high. Key themes from clinician interviews identified possible gaps and limitations: Developmental Trauma and Attachment Difficulties, A different kind of âpatient?â, Seeing the bad but neglecting the sad, and The importance of clinical judgement. Conclusions: Contrary to UK Government policy, this study suggests that the single-report SDQ should not be relied upon as a sole means of identifying mental health difficulties in this vulnerable, high-risk population.Peer reviewedFinal Accepted Versio
Transforming research on morphology into teacher practice
Research suggests that the explicit teaching of morphological principles will improve childrenâs spelling. Despite the fact that reference is made to morphology in English policy documents, teachers make limited use of morphology when teaching spelling, relying more heavily on phonic and visual strategies. After attending a course on role of morphemes in spelling, teachersâ own awareness of morphology increased and this was reflected in their practice. This in turn caused their pupils to make significant gains in spelling, compared to a control group. This reinforces the proposition that explicit instruction about morphemes is helpful to childrenâs learning. It demonstrates the fact that research can be transformed into teacher practice, but it also illustrates the difficulties. Policy documentation alone is insufficient. Professional development can effect change but this may be hard to sustain. Childrenâs gains are contingent on teacherâs continuing to dedicate class time to focussed intervention
Automatic Moment-Closure Approximation of Spatially Distributed Collective Adaptive Systems
Spatially distributed collective adaptive systems are an important class of systems that pose significant challenges to modeling due to the size and complexity of their state spaces. This problem is acute when the dynamic behavior of the system must be captured, such as to predict system performance. In this article, we present an abstraction technique that automatically derives a moment-closure approximation of the dynamic behavior of a spatially distributed collective adaptive system from a discrete representation of the entities involved. The moment-closure technique is demonstrated to give accurate estimates of dynamic behavior, although the number of ordinary differential equations generated for the second-order joint moments can grow large in some cases. For these cases, we propose a rigorous model reduction technique and demonstrate its use to substantially reduce the computational effort with only limited impact on the accuracy if the reduction threshold is set appropriately. All techniques reported in this article are implemented in a tool that is freely available for download
Mechanistic reconciliation of community and invasion ecology
CITATION: Latombe, G., et al. 2021. Mechanistic reconciliation of community and invasion ecology. Ecosphere, 12(2):e03359, doi:10.1002/ecs2.3359.The original publication is available at https://esajournals.onlinelibrary.wiley.comCommunity and invasion ecology have mostly grown independently. There is substantial overlap in the processes captured by different models in the two fields, and various frameworks have been developed to reduce this redundancy and synthesize information content. Despite broad recognition that community and invasion ecology are interconnected, a processâbased framework synthesizing models across these two fields is lacking. Here we review 65 representative community and invasion models and propose a common framework articulated around six processes (dispersal, drift, abiotic interactions, withinâguild interactions, crossâguild interactions, and genetic changes). The framework is designed to synthesize the content of the two fields, provide a general perspective on their development, and enable their comparison. The application of this framework and of a novel method based on network theory reveals some lack of coherence between the two fields, despite some historical similarities. Community ecology models are characterized by combinations of multiple processes, likely reflecting the search for an overarching theory to explain community assembly and structure, drawing predominantly on interaction processes, but also accounting largely for the other processes. In contrast, most models in invasion ecology invoke fewer processes and focus more on interactions between introduced species and their novel biotic and abiotic environment. The historical dominance of interaction processes and their independent developments in the two fields is also reflected in the lower level of coherence for models involving interactions, compared to models involving dispersal, drift, and genetic changes. It appears that community ecology, with a longer history than invasion ecology, has transitioned from the search for single explanations for patterns observed in nature to investigate how processes may interact mechanistically, thereby generating and testing hypotheses. Our framework paves the way for a similar transition in invasion ecology, to better capture the dynamics of multiple alien species introduced in complex communities. Reciprocally, applying insights from invasion to community ecology will help us understand and predict the future of ecological communities in the Anthropocene, in which human activities are weakening speciesâ natural boundaries. Ultimately, the successful integration of the two fields could advance a predictive ecology that is urgently required in a rapidly changing world.https://esajournals.onlinelibrary.wiley.com/doi/full/10.1002/ecs2.3359Publisher's versio
COVID-19 booster vaccination uptake and infection breakthrough amongst health care workers in Wales:A national prospective cohort study
Background: From September 2021, Health Care Workers (HCWs) in Wales began receiving a COVID-19 booster vaccination. This is the first dose beyond the primary vaccination schedule. Given the emergence of new variants, vaccine waning vaccine, and increasing vaccination hesitancy, there is a need to understand booster vaccine uptake and subsequent breakthrough in this high-risk population.
Methods: We conducted a prospective, national-scale, observational cohort study of HCWs in Wales using anonymised, linked data from the SAIL Databank. We analysed uptake of COVID-19 booster vaccinations from September 2021 to February 2022, with comparisons against uptake of the initial primary vaccination schedule. We also analysed booster breakthrough, in the form of PCR-confirmed SARS-Cov-2 infection, comparing to the second primary dose. Cox proportional hazard models were used to estimate associations for vaccination uptake and breakthrough regarding staff roles, socio-demographics, household composition, and other factors.
Results: We derived a cohort of 73,030 HCWs living in Wales (78% female, 60% 18â49 years old). Uptake was quickest amongst HCWs aged 60 + years old (aHR 2.54, 95%CI 2.45â2.63), compared with those aged 18â29. Asian HCWs had quicker uptake (aHR 1.18, 95%CI 1.14â1.22), whilst Black HCWs had slower uptake (aHR 0.67, 95%CI 0.61â0.74), compared to white HCWs. HCWs residing in the least deprived areas were slightly quicker to have received a booster dose (aHR 1.12, 95%CI 1.09â1.16), compared with those in the most deprived areas. Strongest associations with breakthrough infections were found for those living with children (aHR 1.52, 95%CI 1.41â1.63), compared to two-adult only households. HCWs aged 60 + years old were less likely to get breakthrough infections, compared to those aged 18â29 (aHR 0.42, 95%CI 0.38â0.47).
Conclusion: Vaccination uptake was consistently lower among black HCWs, as well as those from deprived areas. Whilst breakthrough infections were highest in households with children
Clinical characteristics associated with the prescribing of SSRI medication in adolescents with major unipolar depression.
Unipolar major depressions (MD) emerge markedly during adolescence. National Institute for Health and Care Excellence (NICE) UK recommends psychological therapies, with accompanying selective serotonin reuptake inhibitors (SSRIs) prescribed in severe cases only. Here, we seek to determine the extent and rationale of SSRI prescribing in adolescent MD before entering a randomised clinical trial. SSRI prescribing, together with their clinical characteristics was determined in 465 adolescent patients with MD prior to receiving a standardised psychological therapy as part of the Improving mood with psychoanalytic and cognitive therapies (IMPACT) clinical trial. Overall, 88 (19Â %) had been prescribed antidepressants prior to psychological treatment. The clinical correlates varied by gender: respectively, depression severity in boys and self-harming behaviours in girls. Prescribing also differed between clinical research centres. Medical practitioners consider severity of depression in boys as an indicator for antidepressant prescribing. Self-injury in girls appears to be utilised as a prescribing aid which is inconsistent with past and current revised UK NICE guidelines.RCT Study supported by a grant to IMG (Chief Investigator) from the NIHR-HTA (trial number ISRCTN83033550, grant number 06/05/01).This is the author accepted manuscript. It is currently under an indefinite embargo pending publication by Springer
Using systems science to understand the determinants of inequities in healthy eating
Introduction: Systems thinking has emerged in recent years as a promising approach to understanding and acting on the prevention and amelioration of non-communicable disease. However, the evidence on inequities in non-communicable diseases and their risks factors, particularly diet, has not been examined from a systems perspective. We report on an approach to developing a system oriented policy actor perspective on the multiple causes of inequities in healthy eating. Methods: Collaborative conceptual modelling workshops were held in 2015 with an expert group of representatives from government, non-government health organisations and academia in Australia. The expert group built a systems model using a system dynamics theoretical perspective. The model developed from individual mind maps to pair blended maps, before being finalised as a causal loop diagram. Results: The work of the expert stakeholders generated a comprehensive causal loop diagram of the determinants of inequity in healthy eating (the HE2Diagram). This complex dynamic system has seven sub-systems: (1) food supply and environment; (2) transport; (3) housing and the built environment; (4) employment; (5) social protection; (6) health literacy; and (7) food preferences. Discussion: The HE2causal loop diagram illustrates the complexity of determinants of inequities in healthy eating. This approach, both the process of construction and the final visualisation, can provide the basis for planning the prevention and amelioration of inequities in healthy eating that engages with multiple levels of causes and existing policies and programs
Drowning in data, thirsty for information and starved for understanding: A biodiversity information hub for cooperative environmental monitoring in South Africa
The world is firmly cemented in a notitian age (Latin: notitia, meaning data) â drowning in data, yet thirsty for information and the synthesis of knowledge into understanding. As concerns over biodiversity declines escalate, the volume, diversity and speed at which new environmental and ecological data are generated has increased exponentially. Data availability primes the research and discovery engine driving biodiversity conservation. South Africa (SA) is poised to become a world leader in biodiversity conservation. However, continent-wide resource limitations hamper the establishment of inclusive technologies and robust platforms and tools for biodiversity informatics. In this perspectives piece, we bring together the opinions of 37 co-authors from 20 different departments, across 10 SA universities, 7 national and provincial conservation research agencies, and various institutes and private conservation, research and management bodies, to develop a way forward for biodiversity informatics in SA. We propose the development of a SA Biodiversity Informatics Hub and describe the essential components necessary for its design, implementation and sustainability. We emphasise the importance of developing a culture of cooperation, collaboration and interoperability among custodians of biodiversity data to establish operational workflows for data synthesis. However, our biggest challenges are misgivings around data sharing and multidisciplinary collaboration
Drowning in data, thirsty for information and starved for understanding: A biodiversity information hub for cooperative environmental monitoring in South Africa
The world is firmly cemented in a notitian age (Latin: notitia, meaning data) â drowning in data, yet thirsty for information and the synthesis of knowledge into understanding. As concerns over biodiversity declines escalate, the volume, diversity and speed at which new environmental and ecological data are generated has increased exponentially. Data availability primes the research and discovery engine driving biodiversity conservation. South Africa (SA) is poised to become a world leader in biodiversity conservation. However, continent-wide resource limitations hamper the establishment of inclusive technologies and robust platforms and tools for biodiversity informatics. In this perspectives piece, we bring together the opinions of 37 co-authors from 20 different departments, across 10 SA universities, 7 national and provincial conservation research agencies, and various institutes and private conservation, research and management bodies, to develop a way forward for biodiversity informatics in SA. We propose the development of a SA Biodiversity Informatics Hub and describe the essential components necessary for its design, implementation and sustainability. We emphasise the importance of developing a culture of cooperation, collaboration and interoperability among custodians of biodiversity data to establish operational workflows for data synthesis. However, our biggest challenges are misgivings around data sharing and multidisciplinary collaboration
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