Technologies for recovery and reuse of plant nutrients from human excreta and domestic wastewater: a protocol for a systematic map and living evidence platform

Background: Research and development on the recovery and reuse of nutrients found in human excreta and domestic wastewater has intensified over the past years, continuously producing new knowledge and technologies. However, research impact and knowledge transfer are limited. In particular, uptake and upscaling of new and innovative solutions in practice remain a key challenge. Achieving a more circular use of nutrients thus goes beyond technological innovation and will benefit from a synthesis of existing research being readily available to various stakeholders in the field. The aim of the systematic map and online evidence platform described in this protocol is threefold. First, to collate and summarise scientific research on technologies that facilitate the recovery and reuse of plant nutrients and organic matter found in human excreta and domestic and municipal wastewater. Second, to present this evidence in a way that can be easily navigated by stakeholders. Third, to report on new relevant research evidence to stakeholders as it becomes available.Methods: Firstly, we will produce a baseline systematic map, which will consist of an extension of two previous related syntheses. In a next stage, with help of machine learning and other automation technologies, the baseline systematic map will be transformed into 'living mode' that allows for a continually updated evidence platform. The baseline systematic map searches will be performed in 4 bibliographic sources and Google Scholar. All searches will be performed in English. Coding and meta-data extraction will include bibliographic information, locations as well as the recovery and reuse pathways. The living mode will mostly rely on automation technologies in EPPI-Reviewer and the Microsoft Academic database. The new records will be automatically identified and ranked in terms of eligibility. Records above a certain 'cut-off' threshold will be manually screened for eligibility. The threshold will be devised based on the empirically informed machine learning model. The evidence from the baseline systematic map and living mode will be embedded in an online evidence platform that in an interactive manner allows stakeholders to visualise and explore the systematic map findings, including knowledge gaps and clusters

Pilot study of a social network intervention for heroin users in opiate substitution treatment: study protocol for a randomized controlled trial

Background: Research indicates that 3% of people receiving opiate substitution treatment (OST) in the UK manage to achieve abstinence from all prescribed and illicit drugs within 3 years of commencing treatment, and there is concern that treatment services have become skilled at engaging people but not at helping them to enter a stage of recovery and drug abstinence. The National Treatment Agency for Substance Misuse recommends the involvement of families and wider social networks in supporting drug users' psychological treatment, and this pilot randomized controlled trial aims to evaluate the impact of a social network-focused intervention for patients receiving OST.Methods and design: In this two-site, early phase, randomized controlled trial, a total of 120 patients receiving OST will be recruited and randomized to receive one of three treatments: 1) Brief Social Behavior and Network Therapy (B-SBNT), 2) Personal Goal Setting (PGS) or 3) treatment as usual. Randomization will take place following baseline assessment. Participants allocated to receive B-SBNT or PGS will continue to receive the same treatment that is routinely provided by drug treatment services, plus four additional sessions of either intervention. Outcomes will be assessed at baseline, 3 and 12 months. The primary outcome will be assessment of illicit heroin use, measured by both urinary analysis and self-report. Secondary outcomes involve assessment of dependence, psychological symptoms, social satisfaction, motivation to change, quality of life and therapeutic engagement. Family members (n = 120) of patients involved in the trial will also be assessed to measure the level of symptoms, coping and the impact of the addiction problem on the family member at baseline, 3 and 12 months.Discussion: This study will provide experimental data regarding the feasibility and efficacy of implementing a social network intervention within routine drug treatment services in the UK National Health Service. The study will explore the impact of the intervention on both patients receiving drug treatment and their family members.Trial registration: Trial Registration Number: ISRCTN22608399. ISRCTN22608399 registration: 27/04/2012. Date of first randomisation: 14/08/2012. © 2013 Day et al.; licensee BioMed Central Ltd

Cannabis use is associated with increased psychotic symptoms and poorer psycho-social functioning in first-episode psychosis: A report from the UK National EDEN study

This is a pre-copyedited, author-produced PDF of an article accepted for publication in Schizophrenia Bulletin following peer review. The version of record Seddon, J. L., et al. (2016). Cannabis Use Is Associated With Increased Psychotic Symptoms and Poorer Psychosocial Functioning in First-Episode Psychosis: A Report From the UK National EDEN Study. Schizophrenia Bulletin, 42(3), 619-625. https://doi.org/10.1093/schbul/sbv154 is available online at: https://academic.oup.com/schizophreniabulletin/article/42/3/619/2413898#39400533Background: The use of cannabis during the early stage of psychosis has been linked with increased psychotic symptoms. This study aimed to examine the use of cannabis in the 12 months following a first-episode psychosis (FEP) and the link with symptomatic course and outcome over one year post psychosis onset. Method: 1027 FEP patients were recruited upon inception to specialised early intervention services for psychosis in the UK. Participants completed assessments at baseline, six and twelve months. Results: The results indicate that the use of cannabis was significantly associated with increased severity of psychotic symptoms, mania, depression and poorer psycho-social functioning. Continued use of cannabis following the first episode of psychosis was prognostic of outcome at one year. These associations were significant after adjusting for age, gender, DUP, age of psychosis onset, ethnicity and other drug use. Conclusion: This is the largest cohort study of first-episode psychosis patients receiving care within early intervention services. Cannabis use, in particular continued use, is associated with poorer symptomatic and functional outcome during the first-episode of psychosis. The results highlight the need for effective and early intervention for cannabis use in FEP

Credible knowledge: A pilot evaluation of a modified GRADE method using parent-implemented interventions for children with autism

Abstract Background Decision-making in child and youth mental health (CYMH) care requires recommendations that are developed through an efficient and effective method and are based on credible knowledge. Credible knowledge is informed by two sources: scientific evidence, and practice-based evidence, that reflects the "real world" experience of service providers. Current approaches to developing these recommendations in relation to CYMH will typically include evidence from one source or the other but do not have an objective method to combine the two. To this end, a modified version of the Grading Recommendations Assessment, Development and Evaluation (GRADE) approach was pilot-tested, a novel method for the CYMH field. Methods GRADE has an explicit methodology that relies on input from scientific evidence as well as a panel of experts. The panel established the quality of evidence and derived detailed recommendations regarding the organization and delivery of mental health care for children and youth or their caregivers. In this study a modified GRADE method was used to provide precise recommendations based on a specific CYMH question (i.e. What is the current credible knowledge concerning the effects of parent-implemented, early intervention with their autistic children?). Results Overall, it appeared that early, parent-implemented interventions for autism result in positive effects that outweigh any undesirable effects. However, as opposed to overall recommendations, the heterogeneity of the evidence required that recommendations be specific to particular interventions, based on the questions of whether the benefits of a particular intervention outweighs its harms. Conclusions This pilot project provided evidence that a modified GRADE method may be an effective and practical approach to making recommendations in CYMH, based on credible knowledge. Key strengths of the process included separating the assessments of the quality of the evidence and the strength of recommendations, transparency in decision-making, and the objectivity of the methods. Most importantly, this method combined the evidence and clinical experience in a more timely, explicit and simple process as compared to previous approaches. The strengths, limitations and modifications of the approach as they pertain to CYMH, are discussed

A large genome-wide association study of age-related macular degeneration highlights contributions of rare and common variants.

This is the author accepted manuscript. The final version is available from Nature Publishing Group via http://dx.doi.org/10.1038/ng.3448Advanced age-related macular degeneration (AMD) is the leading cause of blindness in the elderly, with limited therapeutic options. Here we report on a study of >12 million variants, including 163,714 directly genotyped, mostly rare, protein-altering variants. Analyzing 16,144 patients and 17,832 controls, we identify 52 independently associated common and rare variants (P < 5 × 10(-8)) distributed across 34 loci. Although wet and dry AMD subtypes exhibit predominantly shared genetics, we identify the first genetic association signal specific to wet AMD, near MMP9 (difference P value = 4.1 × 10(-10)). Very rare coding variants (frequency <0.1%) in CFH, CFI and TIMP3 suggest causal roles for these genes, as does a splice variant in SLC16A8. Our results support the hypothesis that rare coding variants can pinpoint causal genes within known genetic loci and illustrate that applying the approach systematically to detect new loci requires extremely large sample sizes.We thank all participants of all the studies included for enabling this research by their participation in these studies. Computer resources for this project have been provided by the high-performance computing centers of the University of Michigan and the University of Regensburg. Group-specific acknowledgments can be found in the Supplementary Note. The Center for Inherited Diseases Research (CIDR) Program contract number is HHSN268201200008I. This and the main consortium work were predominantly funded by 1X01HG006934-01 to G.R.A. and R01 EY022310 to J.L.H

Building a tuberculosis-free world: The Lancet Commission on tuberculosis

___Key messages___ The Commission recommends five priority investments to achieve a tuberculosis-free world within a generation. These investments are designed to fulfil the mandate of the UN High Level Meeting on tuberculosis. In addition, they answer

Cannabis use and abstention in first-episode psychosis: the participants’ view

Cannabis use has been identified as a prognostic factor for poor outcome in first-episode psychosis (FEP). The research aimed to understand the factors that motivate or inhibit the use of cannabis in people with first-episode psychosis. Thirty first-episode psychosis patients (18 cannabis users and 12 abstainers) were interviewed using qualitative semi-structured methods in order to investigate the self reported factors perceived to influence cannabis abstention, initiation, continued use and consumption change. Interviews were transcribed verbatim and analysed using grounded theory based methods. Psychosis specific reasons were not found to be motivationally salient for the initiation or continued use of cannabis, but were found to be important for decreased consumption and cessation. Mental health concerns, such as the impact of cannabis on relapse and psychotic symptom exacerbation were also found to motivate abstention. Psychosis related reasons do not appear to motivate the initial or continued use of cannabis, although thedeleterious effect of cannabis to mental health may promote decreased cannabis consumption, cessation and abstinence following the onset of psychosis. Therefore substance use early interventions for this population should aim to increase emphasis on the potential harms of cannabis to mental health

Perceptions of professional drug treatment staff in England about client barriers to Narcotics Anonymous attendance

A growing body of research evidence shows that Twelve Step Group (TSG) attendance confers a consistent moderate beneficial effect on substance use. Clinicians potentially represent a major referral pathway to TSG. This qualitative study aimed to explore staff perceptions of the barriers to Narcotics Anonymous (NA) group attendance in a population receiving drug treatment, and potential strategies to increase attendance. A cross-sectional survey of substance misuse treatment professionals was conducted between January and April 2012 in Birmingham, England. Fifty-eight members of staff working within statutory community drug treatment teams were interviewed using qualitative research methods. The overarching themes within the staff accounts are described and the importance of these themes explored. Perceived objections to core elements of the 12 step programme (religious nature of the programme, powerlessness, surrender, desire to stop using drugs) were major obstacles to recommending NA attendance. However, a perception that the client would object to any form of group process, and concerns about risk both to the client and the TSG members were also important. Increased education about TSG practices and procedures was a commonly cited strategy for increasing levels of TSG referral, and in particular ensuring that clinicians attend open meetings themselves. An increased understanding and familiarity with the process and principles of TSGs may be necessary to increase promotion of TSG within drug treatment services in line with recent national policy promoting recovery from drug use

Fine scale population structure of dugongs (Dugong dugon) implies low gene flow along the southern Queensland coastline

Populations of marine mammals can show the signature of phylogeographical breaks and restricted connectivity despite the apparent lack of physical boundaries in the marine environment and their high dispersal abilities. Dugongs (Dugong dugon) do not appear to undertake regular migrations but may show localised movement related to water temperature or seagrass availability. Previous mitochondrial DNA studies suggested that despite a strong phylogeographic break in the Torres Strait, there is local panmixia in Australian waters. In this study, we conducted a comprehensive study of the four major dugong populations in southern Queensland. We analysed genotypes of 1,293 dugongs based on 24 microsatellite loci from the four major dugong locations in the region (from south to north): Moreton Bay, Great Sandy Straits, Hervey Bay and Shoalwater Bay. Diversity levels were similar across locations (observed heterozygosity 0.48-0.52, allelic richness 4.3-4.5). There was low but significant population differentiation in southern Queensland (F-ST ranged from 0.005 to 0.040 and Jost's D-EST ranged from 0.001 to 0.031 for microsatellite data). Bayesian clustering analysis implemented in STRUCTURE largely distinguished the southern Moreton Bay population from the three more northern populations. Twelve mitochondrial control region haplotypes identified from a subset of 182 samples confirmed significant population structuring (F-ST ranged from 0.16 to 0.28). These data suggested that the frequency and extent of dugong movements are insufficient to disrupt the long-term existence of at least two breeding populations in southern Queensland