Detecting and Explaining Crisis

Individuals on social media may reveal themselves to be in various states of crisis (e.g. suicide, self-harm, abuse, or eating disorders). Detecting crisis from social media text automatically and accurately can have profound consequences. However, detecting a general state of crisis without explaining why has limited applications. An explanation in this context is a coherent, concise subset of the text that rationalizes the crisis detection. We explore several methods to detect and explain crisis using a combination of neural and non-neural techniques. We evaluate these techniques on a unique data set obtained from Koko, an anonymous emotional support network available through various messaging applications. We annotate a small subset of the samples labeled with crisis with corresponding explanations. Our best technique significantly outperforms the baseline for detection and explanation.Comment: Accepted at CLPsych, ACL workshop. 8 pages, 5 figure

Assessing vulnerability to psychotic illness amongst cannabis users: correlates, discriminating factors and scale development

Background: Schizophrenia is a pervasive and often debilitating disorder, although vulnerability is not easily assessed. Cannabis has a positive relationship with schizophrenia. To date, it is unknown whether or not this is a causal relationship. Nonetheless, those with vulnerability to psychosis have displayed a differential sensitivity to cannabis. Aims: There were two main aims to this programme of research: 1) Contribute to discussions relating to ‘causal inference’ in the relationship between cannabis and psychosis. 2) Assess the reliability and validity of the Cannabis Experiences Questionnaire (CEQ) as a measure of psychotic vulnerability based on a differential sensitivity to cannabis. Methods: Two studies were conducted. The first was a Cross-sectional investigation in which two groups of cannabis users were recruited, participants with self-reported depression (n = 85) and participants with self-reported psychotic disorder (n = 48). This investigation also considered data from a community sample recruited as part of other research studies. These consisted of cannabis users (n = 861) and non-users (n = 306). These groups were compared on measures of schizotypy and cannabis induced experience. The second study was an experience sampling investigation, in which regular cannabis users (n = 36), submitted 7 responses per day via a mobilephone, for a period of 14 days. Participants completed measures of: psychotic-like states, stressed states, calm states, drug consumption, stressful and pleasurable events, and aversive cannabis induced experience. Results: Cross-sectional investigation: There was no significant difference between cannabis users with reported depression and reported psychotic disorder in the disorganised or interpersonal domains of schizotypy. The cannabis-using groups of participants displayed a differential sensitivity to cannabis, with those who reported psychotic illness having significantly more aversive cannabis experiences than the community sample (U = 15106.5, z = 3.142, p = .002, r = 0.10) and participants with reported depression (U = 1241.0, z = 3.746, p < .001, r = 0.32) . The most effective means of identifying psychotic vulnerability consisted of a two-step process, firstly utilising assessments of schizotypy and secondly assessments of aversive cannabis induced experience. Experience sampling investigation: In a dose dependent fashion cannabis predicted increases in interpersonal (b = 0.24 95% CI 0.07 to 0.42, p = .006) and disorganised psychotic like experience (PLE) (b = 0.16 95% CI 0.04 to 0.27, p = .006). However, disorganised PLE significantly increased the odds of cannabis consumption (OR = 1.245 95% CI 1.045 to 1.247, p = .003). Cannabis positively and significantly predicted ‘calm’ states in a dose dependent fashion (b = 0.23 95% CI 0.07 to 0.39, p = .006). Cannabis and stressed states interacted to significantly predict PLEs (b = 0.33, 95% CI 0.17 to 0.49, p < .001). Aversive cannabis induced experience significantly predicted PLEs both within (b = 0.22, 95% CI 0.10 to 0.33, p < .001) and between participants (b = 0.66, 95% CI 0.06 to 1.27, p = .033). Previously documented aversive cannabis experiences significantly predicted propensity to experience stressed states (b = 0.15, 95% CI 0.05 to 0.24, p= .002). Conclusion: Aim 1): Within a continuum model of psychosis the results of these studies support three mechanisms of a cannabis-schizophrenia interaction; cannabis use causes schizophrenia; schizophrenia causes cannabis use; schizophrenia and cannabis use maintain one another. There is evidence to suggest psycho-social stressors interact with cannabis to induce PLEs. This may indicate that cannabis causes schizophrenia via a cross-sensitisation mechanism. At-risk groups should be warned against using cannabis as a stress coping mechanism. Aim 2): These results confirm a differential sensitivity to cannabis in those vulnerable to psychotic disorder. This investigation has demonstrated that psychosis vulnerability can be assessed by aversive cannabis induced experience. This investigation has demonstrated concurrent, convergent, and predictive validity of the CEQ as an assessment of psychotic vulnerability. This scale could be useful for drug education programmes and risk assessment in recreational cannabis users; screening for medicinal cannabis prescription; screening for research trials with cannabinoids or other known psychotomimetics; and in the allocation of psychological intervention for cannabis dependence, and (possibly) stress-reduction in those with disorder or at ultra-high risk

Executive Functioning, Treatment Adherence, and Glycemic Control in Children With Type 1 Diabetes

The primary aim of the study was to investigate the relationship among executive functioning, diabetes treatment adherence, and glycemic control. Two hundred and thirty-five children with type 1 diabetes and their primary caregivers were administered the Diabetes Self-Management Profile to assess treatment adherence. Executive functioning was measured using the Behavior Rating Inventory of Executive Functioning and glycemic control was based on A1C. Structural equation modeling indicated that a model in which treatment adherence mediated the relationship between executive functioning and glycemic control best fit the data. All paths were significant at P < 0.01. These results indicate that executive functioning skills (e.g., planning, problem-solving, organization, and working memory) were related to adherence, which was related to diabetes control. Executive functioning may be helpful to assess in ongoing clinical management of type 1 diabetes

Change in the diet of sooty owls (Tyto tenebricosa) since European settlement: from terrestrial to arboreal prey and increased overlap with powerful owls

The current diet of the sooty owl (Tyto tenebricosa) was determined by analysing freshly regurgitated pellets collected beneath their roosting sites in East Gippsland, Victoria. Comparisons were then made with: (i) prehistoric and historic diet from bone deposits found in cave roosts, and (ii) diet of a sympatric owl species, the powerful owl (Ninox strenua). Sooty owls consumed a large array of terrestrial mammal species before European settlement, but only three terrestrial species were detected in their current diet, a reduction of at least eight species since European settlement. To compensate, sooty owls have increased their consumption of arboreal prey from 55% to 81% of their diet. Arboreal species are also a major component of the powerful owl diet and this prey shift by sooty owls has increased dietary overlap between these two species. Predation by foxes (Vulpes vulpes) and other feral species is likely to have reduced the amount of terrestrial prey available to sooty owls since European settlement. Investigation of changes in the diet of sooty owls may offer a unique monitoring system for evaluating the ability of fox-control strategies to influence increases in numbers of critical-weight-range mammals.<br /

Ethnicity and impact on the receipt of Cognitive Behavioural Therapy in people with psychosis or bipolar disorder:an English cohort study

Objectives: 1) To explore the role of ethnicity in receiving Cognitive Behavioural Therapy (CBT) for people with psychosis or bipolar disorder whilst adjusting for differences in risk profiles and symptom severity. 2) To assess whether context of treatment (inpatient versus community) impacts on the relationship between ethnicity and access to CBT.Design: Cohort study of case-register data from one catchment area (January 2007 to July 2017).Setting: A large secondary care provider serving an ethnically-diverse population in London.Participants: Data extracted for 30,497 records of people who had diagnoses of bipolar disorder (ICD Code F30-1) or psychosis (F20-F29 excluding F21). Exclusion criteria were: <15 years old, missing data, and not self-defining as belonging to one of the larger ethnic groups. The sample (N=20010) comprised the following ethnic groups: White British, n=10393; Black Caribbean, n=5481, Black African, n=2817; Irish, n= 570; and ‘South Asian’people (consisting of Indian, Pakistani, and Bangladeshi people) n=749.Outcome Assessments: Odds ratios for receipt of CBT (single session or full course) as determined via multivariable logistic regression analyses.Results: In models adjusted for risk and severity variables, in comparison to White British people; Black African people were less likely to receive a single session of CBT (OR 0.73, CI 0.66 to 0.82, p<.001); Black Caribbean people were less likely to receive a minimum of 16-sessions of CBT (OR 0.83, CI 0.71 to 0.98, p=.03); Black African and Black Caribbean people were significantly less likely to receive CBT whilst inpatients (respectively OR 0.76, CI 0.65 to 0.89, p=.001; OR 0.83, CI 0.73 to 0.94, p=.003).Conclusions: This study highlights disparity in receipt of CBT from a large provider of secondary care in London for Black African and Caribbean people and that the context of therapy (inpatient versus community settings) has a relationship with disparity in access to treatment

Products as Affective Modifiers of Identities

© The Author(s) 2015. Are salesclerks seen as better, more powerful, or more active when they drive Mustangs? What about entrepreneurs? What about driving a mid-sized car? Intuitively, we have ideas about these, but much of the research on the affective nature of products is on purchasing, desires, and self-fulfillment. Drawing on symbolic interactionism, we argue that people's association with products has some basis in the impression management of their identity. For this to occur, there must be some cultural consensus about the way that products modify identities. Drawing on affect control theory's (ACT) methodology and equations, we measure the goodness, powerfulness, and activeness of several products, identities, and the associated product-modified identities to explore how products function as affective modifiers of identities. We find consistent effects across several types of technology products, whereby products pull the modified identity in the direction of the products' affective qualities. Support is established for the ACT equations that predict how traits modify identities as also having utility for predicting how products modify identities. This suggests that the opening questions can be answered empirically by measuring cultural-specific sentiments of the identity and the product and by developing equations to predict the identity modification process

“They Are Not Hard-to-Reach Clients. We Have Just Got Hard-to-Reach Services.” Staff Views of Digital Health Tools in Specialist Mental Health Services.

Background: Digital health products designed to help people with severe mental health problems appear to be feasible, acceptable, and efficacious. The challenge facing the digital mental health field is implementing digital tools in routine service delivery. To date, there has been a paucity of qualitative research exploring staff views of digital health solutions in the context of mental healthcare. Engaging and involving frontline staff in the design and rollout of new technology to improve utilization is imperative for successful uptake and adoption of digital tools. The aim of the current study is to explore frontline staff views regarding the utility and appropriateness of using digital tools in the healthcare pathway for people accessing specialist secondary care mental health services.Method: Qualitative study using framework analysis was used with 48 mental health staff working in early intervention for psychosis services. Six groups comprising 5–10 early intervention service staff members in each group were conducted across the Northwest of England. Robust measures were used to develop a stable framework, including member checking, triangulation, and consensus meetings.Results: Three themes were identified a priori: i) perceived barriers to adopting smartphone apps for early psychosis; ii) acceptability of digital health tools for early psychosis patients; and iii) data security, safety, and risk. Alongside exploring the a priori topics, one theme was generated a posteriori: iv) relationships.Conclusions: Staff working in specialist early intervention for psychosis services found digital tools on the whole acceptable in mental health service provision, but raised a number of concerns that will likely affect implementation of such systems into routine service delivery and practice. Thirteen recommendations are made in this paper as a result of the themes generated in these data. Implementing of digital systems needs to be simple and uncomplicated and improve clinical workflows for staff rather than hinder and increase clinical workflows. Furthermore, organizational support with a clear plan for implementing technological innovations is required for successful adoption of digital systems. Consideration of staff views around digital systems is important if successful adoption and implementation of such systems are to occur.Clinical Trial Registration: http://www.isrctn.com, identifier ISRCTN34966555

The Influence of Mirror-Visual Feedback on Training-Induced Motor Performance Gains in the Untrained Hand

The well-documented observation of bilateral performance gains following unilateral motor training, a phenomenon known as cross-limb transfer, has important implications for rehabilitation. It has recently been shown that provision of a mirror image of the active hand during unilateral motor training has the capacity to enhance the efficacy of this phenomenon when compared to training without augmented visual feedback (i.e., watching the passive hand), possibly via action observation effects [1]. The current experiment was designed to confirm whether mirror-visual feedback (MVF) during motor training can indeed elicit greater performance gains in the untrained hand compared to more standard visual feedback (i.e., watching the active hand). Furthermore, discussing the mechanisms underlying any such MVF-induced behavioural effects, we suggest that action observation and the cross-activation hypothesis may both play important roles in eliciting cross-limb transfer. Eighty participants practiced a fast-as-possible two-ball rotation task with their dominant hand. During training, three different groups were provided with concurrent visual feedback of the active hand, inactive hand or a mirror image of the active hand with a fourth control group receiving no training. Pre- and post-training performance was measured in both hands. MVF did not increase the extent of training-induced performance changes in the untrained hand following unilateral training above and beyond those observed for other types of feedback. The data are consistent with the notion that cross-limb transfer, when combined with MVF, is mediated by cross-activation with action observation playing a less unique role than previously suggested. Further research is needed to replicate the current and previous studies to determine the clinical relevance and potential benefits of MVF for cases that, due to the severity of impairment, rely on unilateral training programmes of the unaffected limb to drive changes in the contralateral affected limb

Use of multivitamins, folic acid and herbal supplements among breast cancer survivors: the black women's health study

<p>Abstract</p> <p>Background</p> <p>Complementary and alternative medicine (CAM) use, including herbals and multivitamin supplements, is quite common in the U.S., and has been shown to be highest in breast cancer survivors. However, limited data are currently available for CAM usage among African Americans. Thus, we sought to determine the prevalence of multivitamins, folic acid and herbal supplement usage in African American breast cancer survivors, and to compare the characteristics of users and nonusers.</p> <p>Methods</p> <p>A cohort study of breast cancer survivors, who completed the 1999 Black Women's Health Study questionnaire and self-reported having been diagnosed with breast cancer between 1995 and 1999, comprised the study population. In this study, the intake of natural herbs, multivitamins and folic acid at least three days per week within the past two years was used as a proxy for typical usage of this complimentary alternative medicine (CAM) modality.</p> <p>Results</p> <p>A total of 998 breast cancer survivors were identified. Overall, 68.2% had used either herbals or multivitamin supplements or both. The three most frequently used herbals were garlic (21.2%), gingko (12.0%), and echinacea (9.4%). The multivariate analysis determined that single marital status (OR = 1.58; 95%CI: 1.04-2.41), and alcohol consumption of 1-3 drinks per week (OR = 1.86, 95%CI: 1.28-2.68) were significantly associated with increased herbal use. Multivitamin use was significantly lower among obese women (OR = 0.66, 95%CI: 0.46-0.94) and current smokers (OR = 0.53, 95%CI: 0.34-0.82).</p> <p>Conclusions</p> <p>A significant number of African American breast cancer survivors are using herbals and multivitamins as CAM modality. Additional research is needed to understand the impact of herbals and multivitamins in African American breast cancer survivors.</p

Placenta Imaging Workshop 2018 report:Multiscale and multimodal approaches

The Centre for Medical Image Computing (CMIC) at University College London (UCL) hosted a two-day workshop on placenta imaging on April 12th and 13th 2018. The workshop consisted of 10 invited talks, 3 contributed talks, a poster session, a public interaction session and a panel discussion about the future direction of placental imaging. With approximately 50 placental researchers in attendance, the workshop was a platform for engineers, clinicians and medical experts in the field to network and exchange ideas. Attendees had the chance to explore over 20 posters with subjects ranging from the movement of blood within the placenta to the efficient segmentation of fetal MRI using deep learning tools. UCL public engagement specialists also presented a poster, encouraging attendees to learn more about how to engage patients and the public with their research, creating spaces for mutual learning and dialogue