A systematic review on the clustering and co-occurrence of multiple risk behaviours.

BACKGROUND: Risk behaviours, such as smoking and physical inactivity account for up to two-thirds of all cardiovascular deaths, and are associated with substantial increased mortality in many conditions including cancer and diabetes. As risk behaviours are thought to co-occur in individuals we conducted a systematic review of studies addressing clustering or co-occurrence of risk behaviours and their predictors. As the main aim of the review was to inform public health policy in England we limited inclusion to studies conducted in the UK. METHODS: Key databases were searched from 1990 to 2016. We included UK based cross-sectional and longitudinal studies that investigated risk behaviours such as smoking, physical inactivity, unhealthy diet. High heterogeneity precluded meta-analyses. RESULTS: Thirty-seven studies were included in the review (32 cross-sectional and five longitudinal). Most studies investigated unhealthy diet, physical inactivity, alcohol misuse, and smoking. In general adult populations, there was relatively strong evidence of clustering between alcohol misuse and smoking; and unhealthy diet and smoking. For young adults, there was evidence of clustering between sexual risk behaviour and smoking, sexual risk behaviour and illicit drug use, and sexual risk behaviour and alcohol misuse. The strongest associations with co-occurrence and clustering of multiple risk behaviours were occupation (up to 4-fold increased odds in lower SES groups) and education (up to 5-fold increased odds in those with no qualifications). CONCLUSIONS: Among general adult populations, alcohol misuse and smoking was the most commonly identified risk behaviour cluster. Among young adults, there was consistent evidence of clustering found between sexual risk behaviour and substance misuse. Socio-economic status was the strongest predictor of engaging in multiple risk behaviours. This suggests the potential for interventions targeting multiple risk behaviours either sequentially or concurrently particularly where there is evidence of clustering. In addition, there is potential for intervening at the social or environmental level due to the strong association with socio-economic status

Associations between treatment adherence-competence-integrity (ACI) and adult psychotherapy outcomes : a systematic review and meta-analysis.

Author(s) accepted version. 26/09/2022Objective: To provide a comprehensive assessment of the association between psychological treatment adherence/competence/integrity (ACI) and clinical outcomes. Method: The review protocol was pre registered (CRD42020193889). Studies that assessed ACI-outcome relationships for adult psychotherapy were searched across three databases (Scopus, PsycINFO, MEDLINE). Random effects meta-analyses were conducted on adherence-outcome, competence-outcome and integrity-outcome relationships. Separate analyses were performed for studies with hierarchical (i.e. patients nested within therapist) versus non-hierarchical study designs. Moderator analyses were performed according to pre defined clinical and methodological features. GRADE assessments rated the quality of each meta analytic comparison. Results: The review identified 62 studies suitable for inclusion (45 adherence outcome, 39 competence-outcome and 7 integrity-outcome effect sizes; N=8,210 across all analyses). No significant adherence-outcome association was found. A small significant positive association was found only in non-hierarchical studies between competence and outcome (r = 0.17, 95% CI [0.07- 0.26], p < 0.001, ~d = .34, GRADE = moderate). Small-to-moderate significant positive associations between integrity and outcome were found for both non-hierarchical (r = 0.15, 95% CI [0.06 – 0.23], p < 0.001, ~d = .30, GRADE = high) and hierarchical study designs (r = 0.23, 95% CI [0.01,0.43], p < 0.044, ~d = .47, GRADE = low). Diagnosis, treatment modality and year of publication significantly moderated the strength of ACI-outcome correlations. Conclusions: Competence and integrity are significantly associated with clinical outcome, with a magnitude comparable to wider common factors. Further research is required to study these process-outcome associations with greater precision in routine-care settings and to understand the role of moderating variables.https://eprints.whiterose.ac.uk/185434/1/ACI-Meta_ACCEPTED_JCCP.pd

e-Social Science and Evidence-Based Policy Assessment : Challenges and Solutions

Peer reviewedPreprin

A Model of Cooperative Threads

We develop a model of concurrent imperative programming with threads. We focus on a small imperative language with cooperative threads which execute without interruption until they terminate or explicitly yield control. We define and study a trace-based denotational semantics for this language; this semantics is fully abstract but mathematically elementary. We also give an equational theory for the computational effects that underlie the language, including thread spawning. We then analyze threads in terms of the free algebra monad for this theory.Comment: 39 pages, 5 figure

Predicted chance that global warming will temporarily exceed 1.5 °C

The Paris Agreement calls for efforts to limit anthropogenic global warming to less than 1.5 °C above preindustrial levels. However, natural internal variability may exacerbate anthropogenic warming to produce temporary excursions above 1.5 °C. Such excursions would not necessarily exceed the Paris Agreement, but would provide a warning that the threshold is being approached. Here we develop a new capability to predict the probability that global temperature will exceed 1.5 °C above preindustrial levels in the coming 5 years. For the period 2017 to 2021 we predict a 38% and 10% chance, respectively, of monthly or yearly temperatures exceeding 1.5 °C, with virtually no chance of the 5‐year mean being above the threshold. Our forecasts will be updated annually to provide policy makers with advanced warning of the evolving probability and duration of future warming events

Lithological and geochemical characterization of ‘adinole’ artefacts from cave deposits in southwest Wales: a material of choice during the late Middle to Upper Palaeolithic

Twenty-three artefacts previously identified as being manufactured from adinole, a fine-grained metasomatic rock, from late Middle to Upper Palaeolithic cave sites in southwest Wales have been re-examined in terms of their petrology and geochemistry. Standard petrography has been combined with automated SEM-EDS analysis for a single artefact to determine the mineralogy and textures of that artefact, while portable XRF and μXRF have been combined to establish the geochemical characteristics of all twenty-three artefacts analysed. These investigations have shown that the artefacts were manufactured from rhyolite rather than adinole, a misidentification that has been in the literature for over 100 years. Some artefacts appear to cluster on geochemical plots, such as a group of eight artefacts from Hoyle’s Mouth Cave which share petrological characteristics and appear to have come from a common source. In other cases, however, certain artefacts with similar chemistries have dissimilar petrological characteristics and are not from a common source. This highlights the need to consider both petrological and geochemical characteristics when classifying rhyolitic artefacts. The artefacts studied show that this spotted variety of rhyolite was a preferred source of raw material throughout the late Middle and Upper Palaeolithic, despite having no obvious physical or practical advantages. Identifying rhyolite rather than adinole as the raw material used in the manufacture of the studied artefacts negates the need to consider long distance transport of either raw materials or finished artefacts. It strongly suggests that people in southwest Wales, where raw materials were scarce, were using materials that were local to them. Further, there is evidence that people were effectively planning for future use or reuse of artefacts, involving curation of tools. The next phase of work will use the lithological characteristics identified here to explore potential sources for the raw material used in the manufacture of these artefacts

Fine mapping of type 1 diabetes susceptibility loci and evidence for colocalization of causal variants with lymphoid gene enhancers.

Genetic studies of type 1 diabetes (T1D) have identified 50 susceptibility regions, finding major pathways contributing to risk, with some loci shared across immune disorders. To make genetic comparisons across autoimmune disorders as informative as possible, a dense genotyping array, the Immunochip, was developed, from which we identified four new T1D-associated regions (P < 5 × 10(-8)). A comparative analysis with 15 immune diseases showed that T1D is more similar genetically to other autoantibody-positive diseases, significantly most similar to juvenile idiopathic arthritis and significantly least similar to ulcerative colitis, and provided support for three additional new T1D risk loci. Using a Bayesian approach, we defined credible sets for the T1D-associated SNPs. The associated SNPs localized to enhancer sequences active in thymus, T and B cells, and CD34(+) stem cells. Enhancer-promoter interactions can now be analyzed in these cell types to identify which particular genes and regulatory sequences are causal.This research uses resources provided by the Type 1 Diabetes Genetics Consortium, a collaborative clinical study sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the National Institute of Allergy and Infectious Diseases (NIAID), the National Human Genome Research Institute (NHGRI), the National Institute of Child Health and Human Development (NICHD) and JDRF and supported by grant U01 DK062418 from the US National Institutes of Health. Further support was provided by grants from the NIDDK (DK046635 and DK085678) to P.C. and by a joint JDRF and Wellcome Trust grant (WT061858/09115) to the Diabetes and Inflammation Laboratory at Cambridge University, which also received support from the NIHR Cambridge Biomedical Research Centre. ImmunoBase receives support from Eli Lilly and Company. C.W. and H.G. are funded by the Wellcome Trust (089989). The Cambridge Institute for Medical Research (CIMR) is in receipt of a Wellcome Trust Strategic Award (100140). We gratefully acknowledge the following groups and individuals who provided biological samples or data for this study. We obtained DNA samples from the British 1958 Birth Cohort collection, funded by the UK Medical Research Council and the Wellcome Trust. We acknowledge use of DNA samples from the NIHR Cambridge BioResource. We thank volunteers for their support and participation in the Cambridge BioResource and members of the Cambridge BioResource Scientific Advisory Board (SAB) and Management Committee for their support of our study. We acknowledge the NIHR Cambridge Biomedical Research Centre for funding. Access to Cambridge BioResource volunteers and to their data and samples are governed by the Cambridge BioResource SAB. Documents describing access arrangements and contact details are available at http://www.cambridgebioresource.org.uk/. We thank the Avon Longitudinal Study of Parents and Children laboratory in Bristol, UK, and the British 1958 Birth Cohort team, including S. Ring, R. Jones, M. Pembrey, W. McArdle, D. Strachan and P. Burton, for preparing and providing the control DNA samples. This study makes use of data generated by the Wellcome Trust Case Control Consortium, funded by Wellcome Trust award 076113; a full list of the investigators who contributed to the generation of the data is available from http://www.wtccc.org.uk/.This is the author accepted manuscript. The final version is available via NPG at http://www.nature.com/ng/journal/v47/n4/full/ng.3245.html

The Stonehenge Altar Stone was probably not sourced from the Old Red Sandstone of the Anglo-Welsh Basin: time to broaden our geographic and stratigraphic horizons?

Stone 80, the recumbent Altar Stone, is the largest of the Stonehenge foreign “bluestones”, mainly igneous rocks forming the inner Stonehenge circle. The Altar Stone's anomalous lithology, a sandstone of continental origin, led to the previous suggestion of a provenance from the Old Red Sandstone (ORS) of west Wales, close to where the majority of the bluestones have been sourced (viz. the Mynydd Preseli area in west Wales) some 225 km west of Stonehenge. Building upon earlier investigations we have examined new samples from the Old Red Sandstone (ORS) within the Anglo-Welsh Basin (covering south Wales, the Welsh Borderland, the West Midlands and Somerset) using traditional optical petrography but additionally portable XRF, automated SEM-EDS and Raman Spectroscopic techniques. One of the key characteristics of the Altar Stone is its unusually high Ba content (all except one of 106 analyses have Ba &gt; 1025 ppm), reflecting high modal baryte. Of the 58 ORS samples analysed to date from the Anglo-Welsh Basin, only four show analyses where Ba exceeds 1000 ppm, similar to the lower range of the Altar Stone composition. However, because of their contrasting mineralogies, combined with data collected from new automated SEM-EDS and Raman Spectroscopic analyses these four samples must be discounted as being from the source of the Altar Stone. It now seems ever more likely that the Altar Stone was not derived from the ORS of the Anglo-Welsh Basin, and therefore it is time to broaden our horizons, both geographically and stratigraphically into northern Britain and also to consider continental sandstones of a younger age. There is no doubt that considering the Altar Stone as a ‘bluestone’ has influenced thinking regarding the long-held view to a source in Wales. We therefore propose that the Altar Stone should be ‘de-classified’ as a bluestone, breaking a link to the essentially Mynydd Preseli-derived bluestones.</p

Predicting the seasonal evolution of southern African summer precipitation in the DePreSys3 prediction system

We assess the ability of the DePreSys3 prediction system to predict austral summer precipitation (DJF) over southern Africa, defined as the African continent south of 15°S. DePresys3 is a high resolution prediction system (at a horizontal resolution of ~ 60 km in the atmosphere in mid-latitudes and of the quarter degree in the Ocean) and spans the long period 1959–2016. We find skill in predicting interannual precipitation variability, relative to a long-term trend; the anomaly correlation skill score over southern Africa is greater than 0.45 for the first summer (i.e. lead month 2–4), and 0.37 over Mozambique, Zimbabwe and Zambia for the second summer (i.e. lead month 14–16). The skill is related to the successful prediction of the El-Nino Southern Oscillation (ENSO), and the successful simulation of ENSO teleconnections to southern Africa. However, overall skill is sensitive to the inclusion of strong La-Nina events and also appears to change with forecast epoch. For example, the skill in predicting precipitation over Mozambique is significantly larger for the first summer in the 1990–2016 period, compared to the 1959–1985 period. The difference in skill in predicting interannual precipitation variability over southern Africa in different epochs is consistent with a change in the strength of the observed teleconnections of ENSO. After 1990, and consistent with the increased skill, the observed impact of ENSO appears to strengthen over west Mozambique, in association with changes in ENSO related atmospheric convergence anomalies. However, these apparent changes in teleconnections are not captured by the ensemble-mean predictions using DePreSys3. The changes in the ENSO teleconnection are consistent with a warming over the Indian Ocean and modulation of ENSO properties between the different epochs, but may also be associated with unpredictable atmospheric variability