Nurse-Facilitated Health Checks for Persons With Severe Mental Illness: A Cluster-Randomized Controlled Trial

Objective: This study tested the effectiveness of a nurse-delivered health check with the Health Improvement Profile (HIP), which takes approximately 1.5 hours to complete and code, for persons with severe mental illness. Methods: A single-blind, cluster-randomized controlled trial was conducted in England to test whether health checks improved the general medical well-being of persons with severe mental illness at 12-month follow-up. Results: Sixty nurses were randomly assigned to the HIP group or the treatment-as-usual group. From their case lists, 173 patients agreed to participate. HIP group nurses completed health checks for 38 of their 90 patients (42%) at baseline and 22 (24%) at follow-up. No significant between-group differences were noted in patients’ general medical well-being at follow-up. Conclusions: Nurses who had volunteered for a clinical trial administered health checks only to a minority of participating patients, suggesting that it may not be feasible to undertake such lengthy structured health checks in routine practice

Co-creation and co-production in health service delivery: what is it and what impact can it have?

EBN engages through a range of online social media activities to debate issues important to nurses and nursing. EBN Opinion papers highlight and expand on these debates

BSW students under stress: Students’ struggles lead to an innovative response in Aotearoa New Zealand.

Social work students balance multiple roles and responsibilities alongside their educational journey, with recent research suggesting these challenges are exacerbated during practicum. The informal accounts of the pressures and strains on students on the Nelson Marlborough Institute of Technology (NMIT) Bachelor of Social Work (BSW) programme in Aotearoa New Zealand provided impetus for an exploration of the local issues compared with those reported internationally and in different institutional contexts. In 2018, Year three and Year four BSW students were invited to participate in focus groups exploring both the challenges and sustaining factors they encountered during the course of their studies. The findings reveal that, as described in the international literature, NMIT students experience multiple pressures and use a range of support systems to sustain themselves through their student journey. The findings from the study are now informing a review of the structure and delivery of the academic curriculum at NMIT and have led to the development of “He Arawhata”. This programme sits alongside the academic curriculum and is aimed at enhancing the health and wellbeing of students in preparation for the demands of both practicum and a career in social work

Three years of ocean data from a bio-optical profiling float

Ocean color, first measured from space 30 years ago, has provided a revolutionary synoptic view of near-surface fields of phytoplankton pigments. Since 1979, a number of ocean color satellite missions have provided coverage of phytoplankton biomass and other biogeochemical variables on scales of days to years and of kilometers to ocean basin. Because of the nature of visible light and its interaction with absorbing and scattering materials in the ocean and atmosphere, these measurements are biased toward nearsurface waters and are obscured by clouds. As a consequence, ocean color satellites miss significant fractions of phytoplankton biomass, marine primary productivity, and particle flux that occur at depths beyond their sensing range. They also miss phytoplankton blooms and other events that occur during periods of extended cloud cover

A nearby m star with three transiting super-earths discovered by k2

I. J. M. Crossfied, “A Nearby M Star with Three Transiting Super-Earths Discovered by K2”, The Astrophysical Journal, Vol 804(1), April 2015. © 2015. The American Astronomical Society.Small, cool planets represent the typical end-products of planetary formation. Studying the architectures of these systems, measuring planet masses and radii, and observing these planets' atmospheres during transit directly informs theories of planet assembly, migration, and evolution. Here we report the discovery of three small planets orbiting a bright (Ks = 8.6 mag) M0 dwarf using data collected as part of K2, the new ecliptic survey using the re-purposed Kepler spacecraft. Stellar spectroscopy and K2 photometry indicate that the system hosts three transiting planets with radii 1.5-2.1 , straddling the transition region between rocky and increasingly volatile-dominated compositions. With orbital periods of 10-45 days the planets receive just 1.5-10x the flux incident on Earth, making these some of the coolest small planets known orbiting a nearby star; planet d is located near the inner edge of the system's habitable zone. The bright, low-mass star makes this system an excellent laboratory to determine the planets' masses via Doppler spectroscopy and to constrain their atmospheric compositions via transit spectroscopy. This discovery demonstrates the ability of K2 and future space-based transit searches to find many fascinating objects of interest.Peer reviewe

The Role of Race in Admission to a Dual Diagnosis Unit Versus General Inpatient Psychiatric Unit in those with Active Substance Use

Psychiatric disorders are highly comorbid with substance use disorders, and the presence of co-occurring conditions increases severity of illness and complicates recovery. Those with comorbid mental illness and substance use disorders may benefit from specialized services, specifically integrated dual diagnosis treatment. Admission to a dual diagnosis unit requires health care providers to consider a number of factors, including severity of illness, psychiatric history, bed availability, and providers’ perceived likelihood of benefit of specialized services. Ideally, decisions regarding the necessity of substance use treatment are made independent of race, and yet, racial disparities exist among those who are offered substance use treatment. The aim of this study was to evaluate the demographic differences of patients who are identified as having active substance use admitted from the comprehensive psychiatric emergency program (CPEP) to a dual diagnosis unit versus those admitted to a general inpatient psychiatric unit. Our study consists of a retrospective analysis of patients, aged 18–90 (n = 100), admitted to either a dual diagnosis unit (8B) or general psychiatric unit (6K) at Mount Sinai Beth Israel (MSBI), a private metropolitan hospital in New York City, between November 1st to November 30th, 2020. We hypothesized that there are racial disparities in unit assignments while accounting for a variety of potentially relevant demographic and clinical variables. The primary outcome was a comparison of demographic factors, particularly racial composition, of those admitted to the dual diagnosis unit versus those admitted to the general psychiatric unit. After accounting for 6 clinical and 3 other demographic variables, patients of Black race were over 5 times more likely (adjusted odds ratio 5.31; P = 0.011) to be assigned to 8B than patients of White, Asian, or Other race. Additional contributors to 8B assignment were male gender, IM or IV PRNs, and documented substance use ('Table 1'). There were no significant differences between Black and Non-Black patients in rates of substance use detected on toxicology ('Table 2'). These findings suggest that race may be a driving factor in unit assignment, and unconscious racial bias may potentially confound admission decision-making, limiting access to available resources and services for some populations. More research is needed to understand factors contributing to racial disparities in substance use treatment

Phenotypic Characterization of EIF2AK4 Mutation Carriers in a Large Cohort of Patients Diagnosed Clinically With Pulmonary Arterial Hypertension.

BACKGROUND: Pulmonary arterial hypertension (PAH) is a rare disease with an emerging genetic basis. Heterozygous mutations in the gene encoding the bone morphogenetic protein receptor type 2 (BMPR2) are the commonest genetic cause of PAH, whereas biallelic mutations in the eukaryotic translation initiation factor 2 alpha kinase 4 gene (EIF2AK4) are described in pulmonary veno-occlusive disease/pulmonary capillary hemangiomatosis. Here, we determine the frequency of these mutations and define the genotype-phenotype characteristics in a large cohort of patients diagnosed clinically with PAH. METHODS: Whole-genome sequencing was performed on DNA from patients with idiopathic and heritable PAH and with pulmonary veno-occlusive disease/pulmonary capillary hemangiomatosis recruited to the National Institute of Health Research BioResource-Rare Diseases study. Heterozygous variants in BMPR2 and biallelic EIF2AK4 variants with a minor allele frequency of <1:10 000 in control data sets and predicted to be deleterious (by combined annotation-dependent depletion, PolyPhen-2, and sorting intolerant from tolerant predictions) were identified as potentially causal. Phenotype data from the time of diagnosis were also captured. RESULTS: Eight hundred sixty-four patients with idiopathic or heritable PAH and 16 with pulmonary veno-occlusive disease/pulmonary capillary hemangiomatosis were recruited. Mutations in BMPR2 were identified in 130 patients (14.8%). Biallelic mutations in EIF2AK4 were identified in 5 patients with a clinical diagnosis of pulmonary veno-occlusive disease/pulmonary capillary hemangiomatosis. Furthermore, 9 patients with a clinical diagnosis of PAH carried biallelic EIF2AK4 mutations. These patients had a reduced transfer coefficient for carbon monoxide (Kco; 33% [interquartile range, 30%-35%] predicted) and younger age at diagnosis (29 years; interquartile range, 23-38 years) and more interlobular septal thickening and mediastinal lymphadenopathy on computed tomography of the chest compared with patients with PAH without EIF2AK4 mutations. However, radiological assessment alone could not accurately identify biallelic EIF2AK4 mutation carriers. Patients with PAH with biallelic EIF2AK4 mutations had a shorter survival. CONCLUSIONS: Biallelic EIF2AK4 mutations are found in patients classified clinically as having idiopathic and heritable PAH. These patients cannot be identified reliably by computed tomography, but a low Kco and a young age at diagnosis suggests the underlying molecular diagnosis. Genetic testing can identify these misclassified patients, allowing appropriate management and early referral for lung transplantation

Association of genetic variation with systolic and diastolic blood pressure among African Americans: the Candidate Gene Association Resource study

The prevalence of hypertension in African Americans (AAs) is higher than in other US groups; yet, few have performed genome-wide association studies (GWASs) in AA. Among people of European descent, GWASs have identified genetic variants at 13 loci that are associated with blood pressure. It is unknown if these variants confer susceptibility in people of African ancestry. Here, we examined genome-wide and candidate gene associations with systolic blood pressure (SBP) and diastolic blood pressure (DBP) using the Candidate Gene Association Resource (CARe) consortium consisting of 8591 AAs. Genotypes included genome-wide single-nucleotide polymorphism (SNP) data utilizing the Affymetrix 6.0 array with imputation to 2.5 million HapMap SNPs and candidate gene SNP data utilizing a 50K cardiovascular gene-centric array (ITMAT-Broad-CARe [IBC] array). For Affymetrix data, the strongest signal for DBP was rs10474346 (P= 3.6 × 10−8) located near GPR98 and ARRDC3. For SBP, the strongest signal was rs2258119 in C21orf91 (P= 4.7 × 10−8). The top IBC association for SBP was rs2012318 (P= 6.4 × 10−6) near SLC25A42 and for DBP was rs2523586 (P= 1.3 × 10−6) near HLA-B. None of the top variants replicated in additional AA (n = 11 882) or European-American (n = 69 899) cohorts. We replicated previously reported European-American blood pressure SNPs in our AA samples (SH2B3, P= 0.009; TBX3-TBX5, P= 0.03; and CSK-ULK3, P= 0.0004). These genetic loci represent the best evidence of genetic influences on SBP and DBP in AAs to date. More broadly, this work supports that notion that blood pressure among AAs is a trait with genetic underpinnings but also with significant complexit

Housing Design Evaluation Research for People Living with Cognitive Change: A Systematic Literature Review

Research suggests that improvements to home design may enable us to live better with cognitive change as we age. However, few innovations have been fully evaluated. The paper systematically reviews 47 items of evaluative literature. Research design and quality are varied. Qualitative analysis of literature demonstrates the need for a holistic approach that includes older people’s diverse perspectives, examples of promising practice that responds to individual needs, and gaps in research on scalability and economic viability of innovations. The context of design improvements is found to be critical

Velocity structure of upper ocean crust at Ocean Drilling Program Site 1256

Author Posting. © American Geophysical Union, 2008. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Geochemistry Geophysics Geosystems 9 (2008): Q10O13, doi:10.1029/2008GC002188.We examine shipboard physical property measurements, wireline logs, and vertical seismic profiles (VSP) from Ocean Drilling Program/Integrated Ocean Drilling Program Hole 1256D in 15 Ma ocean crust formed at superfast spreading rates to investigate lateral and vertical variations in compressional velocity. In general, velocities from all methods agree. Porosity is inversely related to velocity in both the logging and laboratory data. We infer that microfracturing during drilling is minor in the upper 1 km of basement, probably due to connected pores and, thus, low effective stress. The closure of porosity to very low values coincides with the depth below which laboratory velocities diverge from logging velocities. We infer that porosity controls velocity in layer 2, lithostatic pressure controls the thickness of seismic layer 2, and the distribution of flow types determines seismic velocity in the upper 200 m of basement. In the sheeted dikes, changes in physical properties, mineralogy, and chemistry define clusters of dikes.Funding for this research was provided by Joint Oceanographic Institutions (JOI) Task Order T312A26 and NSF grant OCE-0424633