Non-fatal self-harm in Scottish military veterans: a retrospective cohort study of 57,000 veterans and 173,000 matched non-veterans

Purpose: Although suicide risk in veterans has been widely studied, there is little information on the risk of non-fatal self-harm in this population. We used data from the Scottish Veterans Health Study to conduct an epidemiological analysis of self-harm in veterans, in comparison with people who have never served. Methods: We conducted a retrospective, 30-year cohort study of 56,205 veterans born 1945–1985, and 172,741 people with no record of military service, and used Cox proportional hazard models to examine the association between veteran status and cumulative risk of non-fatal self-harm, overall and stratified by birth cohort, sex and length of service. We also examined mental and physical comorbidities, and association of suicide with prior self-harm. Results: There were 1620 (2.90%) first episodes of self-harm in veterans, compared with 4212 (2.45%) in non-veterans. The difference was statistically significant overall (unadjusted HR 1.27, 95% CI 1.21–1.35, p < 0.001). The risk was highest in the oldest veterans, and in the early service leavers who failed to complete initial training (unadjusted HR 1.69, 95% CI 1.50–1.91, p < 0.001). The risk reduced with longer service and in the intermediate birth cohorts but has increased again in the youngest cohort. Conclusions: The highest risk of non-fatal self-harm was in veterans with the shortest service, especially those who did not complete training or minimum engagement, and in the oldest birth cohorts, whilst those who had served the longest were at reduced risk. The risk has increased again in the youngest veterans, and further study of this subgroup is indicated

DURATION DEPENDENCE IN THE US BUSINESS CYCLE

Durland and McCurdy (1994) investigated the issue of duration dependence in US business cycle phases using a Markov regime switching approach, introduced by Hamilton (1989) and extended to the case of variable transition parameters by Filardo (1994). In Durland and McCurdy’s model duration alone was used as an explanatory of the transition probabilities. They found that recessions were duration dependent whilst expansions were not. In this paper, we explicitly incorporate the widely-accepted US business cycle phase change dates as determined by the NBER, and use a state-dependent multinomial Logit (and Probit) modelling framework. The model incorporates both duration and movements in two leading indexes - one designed to have a short lead (SLI) and the other designed to have a longer lead (LLI) - as potential explanators. We find that doing so suggests that current duration is not only a significant determinant of transition out of recessions, but that there is some evidence that it is also weakly significant in the case of expansions. Furthermore, we find that SLI has more informational content for the termination of recessions whilst LLI does so for expansions.

Childhood IQ and risk of bipolar disorder in adulthood: prospective birth cohort study

Background: Intellectual ability may be an endophenotypic marker for bipolar disorder. Aims: Within a large birth cohort, we aimed to assess whether childhood IQ (including both verbal IQ (VIQ) and performance IQ (PIQ) subscales) was predictive of lifetime features of bipolar disorder assessed in young adulthood. Method: We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a large UK birth cohort, to test for an association between measures of childhood IQ at age 8 years and lifetime manic features assessed at age 22–23 years using the Hypomania Checklist-32 (HCL-32; n=1881 individuals). An ordinary least squares linear regression model was used, with normal childhood IQ (range 90–109) as the referent group. We adjusted analyses for confounding factors, including gender, ethnicity, handedness, maternal social class at recruitment, maternal age, maternal history of depression and maternal education. Results: There was a positive association between IQ at age 8 years and lifetime manic features at age 22–23 years (Pearson's correlation coefficient 0.159 (95% CI 0.120–0.198), P>0.001). Individuals in the lowest decile of manic features had a mean full-scale IQ (FSIQ) which was almost 10 points lower than those in the highest decile of manic features: mean FSIQ 100.71 (95% CI 98.74–102.6) v. 110.14 (95% CI 107.79–112.50), P>0.001. The association between IQ and manic features was present for FSIQ, VIQ and for PIQ but was strongest for VIQ. Conclusions: A higher childhood IQ score, and high VIQ in particular, may represent a marker of risk for the later development of bipolar disorder. This finding has implications for understanding of how liability to bipolar disorder may have been selected through generations. It will also inform future genetic studies at the interface of intelligence, creativity and bipolar disorder and is relevant to the developmental trajectory of bipolar disorder. It may also improve approaches to earlier detection and treatment of bipolar disorder in adolescents and young adults

LoCuSS: Hydrostatic Mass Measurements of the High-LXL_X Cluster Sample -- Cross-calibration of Chandra and XMM-Newton

We present a consistent analysis of Chandra and XMM-Newton observations of an approximately mass-selected sample of 50 galaxy clusters at $0.15<z<0.3$ -- the "LoCuSS High-$L_X$ Sample". We apply the same analysis methods to data from both satellites, including newly developed analytic background models that predict the spatial variation of the Chandra and XMM-Newton backgrounds to $<2\%$ and $<5\%$ precision respectively. To verify the cross-calibration of Chandra and XMM-Newton-based cluster mass measurements, we derive the mass profiles of the 21 clusters that have been observed with both satellites, extracting surface brightness and temperature profiles from identical regions of the respective datasets. We obtain consistent results for the gas and total hydrostatic cluster masses: the average ratio of Chandra- to XMM-Newton-based measurements of $M_{\rm gas}$ and $M_X$ at $r_{500}$ are $0.99\pm0.02$ and $1.02\pm0.05$, respectively with an intrinsic scatter of $\sim3\%$ for gas masses and $\sim8\%$ for hydrostatic masses. Comparison of our hydrostatic mass measurements at $r_{500}$ with the latest LoCuSS weak-lensing results indicate that the data are consistent with non-thermal pressure support at this radius of $\sim7\%$. We also investigate the scaling relation between our hydrostatic cluster masses and published integrated Compton parameter $Y_{sph}$ measurements from the Sunyaev-Zel'dovich Array. We measure a scatter in mass at fixed $Y_{sph}$ of $\sim16\%$ at $\Delta=500$, which is consistent with theoretical predictions of $\sim10-15\%$ scatter.Comment: 21 pages, 11 figure

Apgar score and the risk of cause specific infant mortality: a population based cohort study of 1,029,207 livebirths

Background&lt;p&gt;&lt;/p&gt; The Apgar score has been used worldwide as an index of early neonatal condition for more than 60 years. With advances in health-care service provision, neonatal resuscitation, and infant care, its present relevance is unclear. The aim of the study was to establish the strength of the relation between Apgar score at 5 min and the risk of neonatal and infant mortality, subdivided by specific causes.&lt;p&gt;&lt;/p&gt; Methods&lt;p&gt;&lt;/p&gt; We linked routine discharge and mortality data for all births in Scotland, UK between 1992 and 2010. We restricted our analyses to singleton livebirths, in women aged over 10 years, with a gestational age at delivery between 22 and 44 weeks, and excluded deaths due to congenital anomalies or isoimmunisation. We calculated the relative risks (RRs) of neonatal and infant death of neonates with low (0–3) and intermediate (4–6) Apgar scores at 5 min referent to neonates with normal Apgar score (7–10) using binomial log-linear modelling with adjustment for confounders. Analyses were stratified by gestational age at birth because it was a significant effect modifier. Missing covariate data were imputed.&lt;p&gt;&lt;/p&gt; Findings&lt;p&gt;&lt;/p&gt; Complete data were available for 1 029 207 eligible livebirths. Across all gestational strata, low Apgar score at 5 min was associated with an increased risk of neonatal and infant death. However, the strength of the association (adjusted RR, 95% CI referent to Apgar 7–10) was strongest at term (p&#60;0·0001). A low Apgar (0–3) was associated with an adjusted RR of 359·4 (95% CI 277·3–465·9) for early neonatal death, 30·5 (18·0–51·6) for late neonatal death, and 50·2 (42·8–59·0) for infant death. We noted similar associations of a lower magnitude for intermediate Apgar (4–6). The strongest associations were for deaths attributed to anoxia and low Apgar (0–3) for term infants (RR 961·7, 95% CI 681·3–1357·5) and preterm infants (141·7, 90·1–222·8). No association between Apgar score at 5 min and the risk of sudden infant death syndrome was noted at any gestational age (RR 0·6, 95% CI 0·1–4·6 at term; 1·2, 0·3–4·8 at preterm).&lt;p&gt;&lt;/p&gt; Interpretation&lt;p&gt;&lt;/p&gt; Low Apgar score at 5 min was strongly associated with the risk of neonatal and infant death. Our findings support its continued usefulness in contemporary practice

Dendroglaciological Dating of a Little Ice Age Glacial Advance at Moving Glacier, Vancouver Island, British Columbia

Dendrochronological investigations at Moving Glacier provide the first calendar-dating of a Little Ice Age glacier advance on Vancouver Island. In 1931, Moving Glacier was within 30 to 50 m of a distinct trimline and terminal moraine marking its maximum Little Ice Age extent. A reconnaissance of the site in 1993 revealed the presence of sheared in situ stumps and detrital trunks inside the 1931 ice limit. Sampling in 1994 showed the site was covered by a mature subalpine forest prior to the glacial advance which overrode the site after 1718 A.D. Following this period of expansion, which saw Moving Glacier expand to its maximum Little Ice Age position after 1818 A.D., the glacier apparently experienced only minimal retreat prior to first being photographed in 1931.Des recherches en dendrochronologie menées sur le glacier Moving ont permis de dater l'évolution d'un glacier au Petit Âge glaciaire. En 1931, Le glacier Moving était situé entre 30 et 50 m d'un épaulement et d'une moraine frontale correspondant à sa limite d'expansion maximale au Petit Âge glaciaire. L'exploration du site en 1993 a permis de découvrir des souches et des débris de bois in situ à l'intérieur de la limite glaciaire de 1931. Un échantillonnage effectué en 1994 a montré que le site était recouvert d'une forêt subalpine mûre avant l'avancée glaciaire qui a bouleversé le site après 1718 ap. J.-C. Après la période d'expansion, qui a permis au glacier d'atteindre sa limite maximale après 1818 ap. J.-C, le glacier a connu un recul minimal avant d'être photographié en 1931.Dendrochnronologische Forschungen am Moving-Gletscher ergeben die erste Kalenderdatierung eines GletschervorstoBes wâhrend der kleinen Eiszeit auf der Insel Vancouver. 1931 befand sich der Moving-Gletscher innerhalb der 30 bis 50 m einer klaren Abflachung und der Endmorâne, was seiner maximalen Ausdehnung in der kleinen Eiszeit entsprach. 1993 fand man bei der Erkundung des Platzes in situ abgescherte Baumstùmpfe und Trùmmer von Baumstâmmen innerhalb der Eisgrenze von 1931. 1994 zeigte eine Probenentnahme, daf3 der Platz mit einem ausgewachsenen subalpinen WaId bewachsen war, bevor der glaziale VorstoB den Platz nach 1718 u.Z. verwandelte. Nach dieser Ausdehnungs-periode, in welcher der Moving-Gletscher nach 1818 u.Z. seine maximale Position in der kleinen Eiszeit erreichte, hat der Gletscher offenbar nur einen minimalen Rùckzug vollzogen, bevor er 1931 zum 1. Mal photographiert wurde

Recent Cases

Courts Split on the Necessity of Separate Authorization for a Covert Entry Under Title III of the Omnibus Crime Control and Safe Streets Act of 1968 Daniel Paul Smith Title III of the Omnibus Crime Control and Safe Streets Act of 1968,\u27 which regulates the use of electronic surveillance, was designed to protect the privacy of wire and oral communications, and to delineate on a uniform basis the circumstances and conditions under which the interception of wire and oral communications may be authorized. \u27 In general, communications may be intercepted only by law enforcement officers, who are engaged in the investigation of a certain type of crime, and who have obtained a court order based upon probable cause that authorizes the use of electronic surveillance. Although certain details of the particular interception must be specified in the court order, the statute does not expressly require that the judge who authorizes the use of electronic surveillance also authorize covert entries that may be required to place the electronic listening devices Until recently the federal courts apparently had assumed that an order authorizing the use of electronic surveillance implicitly authorized a surreptitious entry by law enforcement officials to install the necessary device. In United States v. Ford, however, the District of Columbia Circuit became the first federal court of appeals to reject this assumption, holding that absent express judicial authorization, a trespassory entry incident to the placement of an electronic listening device is an invasion of privacy that violates the fourth amendment. =============== ================= =========== Custodial Suspect\u27s Admissions After Assertion and Subsequent Waiver of Right to Counsel Are Not Per Se Excluded in Absence of Coercion R. Michael Moore The holding in this case carries the trend toward reinterpretation of Miranda to an undesirable extreme. Although the rejection of the per se rule will diminish the number of reversals of factually correct convictions, relegating the protection of the right to counsel to the same analysis employed in right to silence cases operates an injustice on criminal suspects. The request for an attorney should trigger greater protection because every effort should be made to insure that the suspect exercises his judgment intelligently. Despite the Supreme Court\u27s retrenchment from the Miranda assumption that all custodial interrogations are inherently coercive, coercion remains a problem, especially where a suspect is confused or unable to exercise his rights intelligently. Thus implementation of a strict waiver test is necessary to secure a suspect\u27s rights in the absence of the per se rule