Encouraging planting in urban front gardens: a focus group study.

AIMS: Encouraging planting in front gardens offers mental and physical health benefits, as well as positive local environmental impacts such as reducing flood risk and improving air quality. However, urban front garden greenery has reduced in recent years. We aimed to explore adults' views regarding planting greenery in front gardens, barriers and facilitators, and their understanding of health and environmental impacts, to identify appropriate intervention mechanisms for behaviour change. METHODS: We carried out five online focus groups with 20 participants aged 20-64 in England, purposively sampled for variation according to age, gender, home ownership, income, ethnicity and residing in an urban or suburban area. We audio recorded each focus group, transcribed it verbatim and analysed transcripts using thematic analysis. RESULTS: Front gardening was a relaxing activity that provided benefits including increased wellbeing, fresh air and vitamin D. Planting in front gardens depended heavily on available time and space, garden orientation, local security and the weather. Front gardens could be a place for social interaction. Participants tended to prioritise neatness and tidiness over greenery. Lack of knowledge and low self-efficacy were key barriers. There was little awareness of the environmental benefits of front garden greenery; however, reducing flood risk and encouraging biodiversity were viewed positively. CONCLUSION: Initiatives to encourage front garden planting should focus on plants that require little knowledge to acquire and care for, are suitable to the local environmental conditions and with a visual impact of neatness and bright colour. Campaigns should draw attention to local flood risk reduction and increasing biodiversity, in addition to personal health benefits.

Assessing the factorial validity and the internal reliability of the International Trauma Questionnaire (ITQ); PTSD and complex PTSD among survivors of sexual violence in Ireland.

AIMS: To assess the factorial validity and internal reliability of the International Trauma Questionnaire (ITQ) among a treatment-seeking sample of survivors of sexual violence in Ireland. In addition, to assess the diagnostic rate of post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD) among the samples. METHODS: Participants were adult survivors of sexual violence (N = 114) in receipt of therapeutic support at the Dublin Rape Crisis Centre. The ITQ was utilised to measure PTSD and CPTSD symptoms and confirmatory factor analysis was employed to assess the factorial validity of the ITQ. Composite reliability was employed to assess the internal reliability of the ITQ scale scores. RESULTS: The confirmatory factor analysis results indicated that a six-factor correlated model and a two-factor higher model were good representations of the latent structure of the ITQ, both models are consistent with the conceptualisation of CPTSD. All ITQ subscales possessed satisfactory internal reliability except for the affective dysregulation subscale. Of the sample, 56.1% met the criteria for CPTSD and 20.2% met the criteria for PTSD. CONCLUSIONS: The ITQ captured a distinction between PTSD and CPTSD symptoms and produced reliable scores within the sample, but replication with a larger sample size is required. In addition, the study findings demonstrated that CPTSD was relatively common among those seeking psychological support following sexual violence.

Sarcopenic Obesity and Depression: A Systematic Review.

BACKGROUND: Sarcopenic obesity (SO) is a condition combining two important public health issues commonly seen amongst older individuals, obesity and sarcopenia. Depressive symptoms are common among older people, whose population is increasing worldwide. Obesity and sarcopenia alone, are clearly associated with depression while the coexistence of these two conditions (SO) upon depressive disorders is currently unclear. We aimed to systematically review the association between primary SO and depressive disorders. METHODS: Searches were run on MEDLINE, EMBASE, PsycINFO, and CINAHL (inception to June 2019). One reviewer screened titles, abstracts, and full-texts, with 10% checked independently by a second reviewer. Cohort and cross-sectional studies were included. Two reviewers independently assessed risk of bias using the Mixed Methods Appraisal Tool. Results were narratively synthesised. RESULTS: Out of the 7 studies eligible for inclusion, evidence of sarcopenic obesity as a predictor of depressive symptoms was found in two studies. The main observed trend was that diagnosing sarcopenia using muscle strength led to significant associations between sarcopenic obesity and depressive symptoms. Two cross-sectional studies found a significant association between SO and depressive symptoms, whilst three others found no statistically significant associations. All possessed some methodological limitations. DISCUSSION: This is the first review to systematically examine a potential relationship between sarcopenic obesity and depressive disorders. Currently, the results are heterogeneous due to the large variability in assessment methods and outcome measurements. Future longitudinal studies would achieve greater confidence in the provisional conclusion that sarcopenic obesity, when measured using muscle strength, is associated with depressive symptoms.

Day-of-Injury Computed Tomography and Longitudinal Rehabilitation Outcomes: A Comparison of the Marshall and Rotterdam Computed Tomography Scoring Methods.

OBJECTIVE: The aim of the study was to compare the relative predictive value of Marshall Classification System and Rotterdam scores on long-term rehabilitation outcomes. This study hypothesized that Rotterdam would outperform Marshall Classification System. DESIGN: The study used an observational cohort design with a consecutive sample of 88 participants (25 females, mean age = 42.0 [SD = 21.3]) with moderate to severe traumatic brain injury who were admitted to trauma service with subsequent transfer to the rehabilitation unit between February 2009 and July 2011 and who had clearly readable computed tomography scans. Twenty-three participants did not return for the 9-mo postdischarge follow-up. Day-of-injury computed tomography images were scored using both Marshall Classification System and Rotterdam criteria by two independent raters, blind to outcomes. Functional outcomes were measured by length of stay in rehabilitation and the cognitive and motor subscales of the Functional Independence Measure at rehabilitation discharge and 9-mo postdischarge follow-up. RESULTS: Neither Marshall Classification System nor Rotterdam scales as a whole significantly predicted Functional Independence Measure motor or cognitive outcomes at discharge or 9-mo follow-up. Both scales, however, predicted length of stay in rehabilitation. Specific Marshall scores (3 and 6) and Rotterdam scores (5 and 6) significantly predicted subacute outcomes such as Functional Independence Measure cognitive at discharge from rehabilitation and length of stay. CONCLUSIONS: Marshall Classification System and Rotterdam scales may have limited utility in predicting long-term functional outcome, but specific Marshall and Rotterdam scores, primarily linked to increased severity and intracranial pressure, may predict subacute outcomes.

Reversal of apixaban anticoagulation by four-factor prothrombin complex concentrates in healthy subjects: a randomized three-period crossover study.

Essentials Prothrombin complex concentrates (PCCs) may reverse the effect of factor Xa (FXa) inhibitors. We conducted an open-label, randomized, placebo-controlled, three-period crossover study in 15 subjects. Both PCCs rapidly reversed apixaban-mediated decreases in mean endogenous thrombin potential. Four-factor PCC administration had no effect on apixaban pharmacokinetics or anti-FXa activity. SUMMARY: Background Currently, there is no approved reversal agent for direct activated factor Xa (FXa) inhibitors; however, several agents are under investigation, including prothrombin complex concentrates (PCCs). Objective This open-label, randomized, placebo-controlled, three-period crossover study assessed the effect of two four-factor PCCs on apixaban pharmacodynamics and pharmacokinetics in 15 healthy subjects. Methods Subjects received apixaban 10 mg twice daily for 3 days. On day 4, 3 h after apixaban, subjects received a 30-min infusion of 50 IU kg-1 Cofact, Beriplex P/N (Beriplex), or saline. Change in endogenous thrombin potential (ETP), measured with a thrombin generation assay (TGA), was the primary endpoint. Secondary endpoints included changes in other TGA parameters, prothrombin time (PT), International Normalized Ratio (INR), activated partial thromboplastin time, anti-FXa activity, apixaban pharmacokinetics, and safety. Results Apixaban-related changes in ETP and several other pharmacodynamic measures occurred following apixaban administration. Both PCCs reversed apixaban's effect on ETP; the differences in adjusted mean change from pre-PCC baseline to end of infusion were 425 nm min (95% confidence interval [CI] 219.8-630.7 nm min; P < 0.001) for Cofact, and 91 nm min (95% CI - 31.3 to 212.4 nm min; P > 0.05) for Beriplex. Both PCCs returned ETP to pre-apixaban baseline levels 4 h after PCC infusion, versus 45 h for placebo. For both PCCs, mean ETP peaked 21 h after PCC initiation, and then slowly decreased over the following 48 h. Both PCCs reversed apixaban's effect on TGA peak height, PT, and INR. Apixaban pharmacokinetic and anti-FXa profiles were consistent across treatments. Conclusions Cofact and Beriplex reversed apixaban's steady-state effects on several coagulation assessments.

Volumetric analysis of day of injury computed tomography is associated with rehabilitation outcomes after traumatic brain injury.

BACKGROUND: Day-of-injury (DOI) brain lesion volumes in traumatic brain injury (TBI) patients are rarely used to predict long-term outcomes in the acute setting. The purpose of this study was to investigate the relationship between acute brain injury lesion volume and rehabilitation outcomes in patients with TBI at a level one trauma center. METHODS: Patients with TBI who were admitted to our rehabilitation unit after the acute care trauma service from February 2009-July 2011 were eligible for the study. Demographic data and outcome variables including cognitive and motor Functional Independence Measure (FIM) scores, length of stay (LOS) in the rehabilitation unit, and ability to return to home were obtained. The DOI quantitative injury lesion volumes and degree of midline shift were obtained from DOI brain computed tomography scans. A multiple stepwise regression model including 13 independent variables was created. This model was used to predict postrehabilitation outcomes, including FIM scores and ability to return to home. A p value less than 0.05 was considered significant. RESULTS: Ninety-six patients were enrolled in the study. Mean age was 43 ± 21 years, admission Glasgow Coma Score was 8.4 ± 4.8, Injury Severity Score was 24.7 ± 9.9, and head Abbreviated Injury Scale score was 3.73 ± 0.97. Acute hospital LOS was 12.3 ± 8.9 days, and rehabilitation LOS was 15.9 ± 9.3 days. Day-of-injury TBI lesion volumes were inversely associated with cognitive FIM scores at rehabilitation admission (p = 0.004) and discharge (p = 0.004) and inversely associated with ability to be discharged to home after rehabilitation (p = 0.006). CONCLUSION: In a cohort of patients with moderate to severe TBI requiring a rehabilitation unit stay after the acute care hospital stay, DOI brain injury lesion volumes are associated with worse cognitive FIM scores at the time of rehabilitation admission and discharge. Smaller-injury volumes were associated with eventual discharge to home. Volumetric neuroimaging in the acute injury phase may improve surgeons' ultimate outcome predictions in TBI patients. LEVEL OF EVIDENCE: Prognostic/epidemiologic study, level V.

Hoarding and emotional reactivity: the link between negative emotional reactions and hoarding symptomatology.

Hoarding disorder (HD) is characterized by difficulty discarding, clutter, and frequently excessive acquiring. Theories have pointed to intense negative emotional reactions (e.g., sadness) as one factor that may play a critical role in HD's etiology. Preliminary work with an analogue sample indicated that more intense negative emotions following emotional films were linked with greater hoarding symptoms. Symptom provocation imaging studies with HD patients have also found evidence for excessive activation in brain regions implicated in processing emotions. The current study utilized a sample with self-reported serious hoarding difficulties to examine how hoarding symptoms related to both general and hoarding-related emotional reactivity, taking into account the specificity of these relationships. We also examined how two cognitive factors, fear of decision-making and confidence in memory, modified this relationship. 628 participants with self-identified hoarding difficulties completed questionnaires about general emotional reactivity, depression, anxiety, decision-making, and confidence in memory. To assess hoarding-related emotional reactivity, participants reported their emotional reactions when imagining discarding various items. Heightened general emotional reactivity and more intense emotional reactions to imagined discarding were associated with both difficulty discarding and acquisition, but not clutter, controlling for age, gender, and co-occurring mood and anxiety symptoms. Fear of decision-making and confidence in memory interacted with general emotional reactivity to predict hoarding symptoms. These findings provide support for cognitive-behavioral models of hoarding. Experimental research should be conducted to discover whether emotional reactivity increases vulnerability for HD. Future work should also examine whether emotional reactivity should be targeted in interventions for hoarding.

Clinical correlates of distorted auditory perception in first-episode psychosis.

AIM: Auditory hallucinations are hypothesized to be based in distorted sensory perceptions, with increasingly distorted perceptions of reality possibly prompting the first psychotic phase of schizophrenia spectrum disorders. Our goal was to examine the association between distorted auditory perceptions and psychotic symptomatology, social functioning and quality of life among individuals with first-episode psychosis. METHODS: Forty individuals with first-episode psychosis completed assessments of distorted auditory perception, psychotic symptomatology, social functioning and quality of life. RESULTS: Both negative (greater symptomatology) and positive clinical correlates (better quality of life) were associated with greater distorted auditory perceptions. CONCLUSIONS: Our findings suggest that distorted auditory perceptions are associated with both positive and negative clinical correlates among individuals with first-episode psychosis. These results highlight the potential clinical importance of balancing the goal of symptomatic reduction with the need to maintain healthy coping strategies that may be biologically and psychologically entwined with the symptoms of psychosis, themselves.

Spectroscopic characterization of manganese minerals.

Manganese minerals ardenite, alleghanyite and leucopoenicite originated from Madhya Pradesh, India, Nagano prefecture Japan, Sussex Country and Parker Shaft Franklin, Sussex Country, New Jersey respectively are used in the present work. In these minerals manganese is the major constituent and iron if present is in traces only. An EPR study of on all of the above samples confirms the presence of Mn(II) with g around 2.0. Optical absorption spectrum of the mineral alleghanyite indicates that Mn(II) is present in two different octahedral sites and in leucophoenicite Mn(II) is also in octahedral geometry. Ardenite mineral gives only a few Mn(II) bands. NIR results of the minerals ardenite, leucophoenicite and alleghanyite are due to hydroxyl and silicate anions which confirming the formulae of the minerals.

A critical scoping review of external uses of comfrey (Symphytum spp.).

BACKGROUND: External preparations of the herb comfrey (most commonly Symphytum officinale L.) are widely available for over-the-counter, practitioner and healthcare professional usage. Traditional practice suggests comfrey can be used to treat musculoskeletal disorders, wounds and various other conditions; however a full and critical coverage of the evidence base has not yet been undertaken. METHODS: A critical scoping review was undertaken. Six bibliographic databases, 10 grey literature databases and nine trials registers were searched plus reference lists of included studies and a descriptive overview of comfrey. Randomised or non-randomised clinical trials assessing the external use of comfrey for any indication were included and methodological and reporting quality were assessed. Observational studies were included only in the assessment of adverse events. Studies were grouped and summarised according to the type of indication treated. RESULTS: Of 1348 identified records, 64 full texts were screened for inclusion and 26 were included in the review - 13 RCTs, 5 non-randomised controlled trials and 8 observational studies evaluating treatments for ankle distortion, back pain, abrasion wounds, venous leg ulcers and osteoarthritis. The majority of included trials had an overall unclear risk of bias due to poor quality of reporting. Few adverse events were reported. CONCLUSIONS: Individual clinical trials showed evidence of benefit for ankle distortion, back pain, abrasion wounds and osteoarthritis. Topical application appears to be safe but further rigorous assessment is needed. Systematic reviews focussing on particular indications may clarify the treatment effect and safety of external comfrey preparations.

Prevalence of traumatic brain injury in the general adult population: a meta-analysis.

Traumatic brain injury (TBI) is a significant public-health concern. To understand the extent of TBI, it is important to assess the prevalence of TBI in the general population. However, the prevalence of TBI in the general population can be difficult to measure because of differing definitions of TBI, differing TBI severity levels, and underreporting of sport-related TBI. Additionally, prevalence reports vary from study to study. In this present study, we used meta-analytic methods to estimate the prevalence of TBI in the adult general population. Across 15 studies, all originating from developed countries, which included 25,134 adults, 12% had a history of TBI. Men had more than twice the odds of having had a TBI than did women, suggesting that male gender is a risk factor for TBI. The adverse behavioral, cognitive and psychiatric effects associated with TBI coupled with the high prevalence of TBI identified in this study indicate that TBI is a considerable public and personal-health problem.

Prevalence of traumatic brain injury in juvenile offenders: a meta-analysis.

Studies of traumatic brain injury (TBI) among adult populations demonstrate that such injuries can lead to aggressive behaviors. Related findings suggest that incarcerated individuals have high rates of brain injuries. Such studies suggest that traumatic brain injury may be related to the etiology and recidivism of criminal behavior. Relatively few studies have examined the prevalence of TBI using a delinquent juvenile sample. In order to assess the relationship between TBI and juvenile offender status, the current study used meta-analytic techniques to examine the odds of having a TBI among juvenile offenders. Across 9 studies, we found that approximately 30% of juvenile offenders have sustained a previous brain injury. Across 5 studies that used a control group, a calculated summary odds ratio of 3.37 suggests that juvenile offenders are significantly more likely to have a TBI compared to controls. Results suggest that the rate of TBIs within the juvenile offender population is significant and that there may be a relationship between TBIs and juvenile criminal behavior.

Body dissatisfaction among pre-adolescent girls is predicted by their involvement in aesthetic sports and by personal characteristics of their mothers.

Empirical evidence indicates that the dissatisfaction with one's body is widely present in the general population even at very early ages, and that it is predictive of future eating disorders. The family seem particularly influent for the development of body dissatisfaction while sports practice is associated to a higher prevalence of disordered eating. However the role of sports practice in the development of body dissatisfaction is still under debate and only few studies have evaluated together the influences of family and sport practice on body dissatisfaction. The present study aimed at evaluating both the singular and conjoint role of the type of sport and maternal influences in young female children. The sport influence was assessed comparing aesthetic and non-aesthetic disciplines; the mother's influence was evaluated considering her personal characteristics and her desire to have a thinner child. Results evidence that children involved in aesthetic sports, although thinner than those involved in non-aesthetic sports, report higher desire to be much thinner and have mothers who pressure them toward a greater thinness. Furthermore, children's body dissatisfaction in the sport groups is predicted by maternal characteristic like her habit to restrict her own eating and her perfectionism.

Prevalence of traumatic brain injury in intimate partner violence offenders compared to the general population: a meta-analysis.

Intimate partner violence (IPV) is widespread. Several risk factors are associated with IPV perpetuation, including alcohol use and educational level. The aggression and violence associated with traumatic brain injury (TBI) suggest that brain trauma may also be a risk factor for IPV. To examine the association between TBI and IPV, the authors conducted a meta-analysis of peer-reviewed published studies reporting the prevalence of TBI in IPV perpetrators. The authors compared the frequency of TBI among IPV perpetuators to estimates of TBI in the general population using a single-sample test of proportions. Six studies containing a total of 222 subjects met inclusion criteria. Fifty-three percent (119) of the IPV perpetuators had a history of TBI, a prevalence significantly higher (p < .0001) than estimates of TBI in the general population. The prevalence of TBI among perpetuators of IPV appears significantly higher than the prevalence of TBI in the general population. To the extent that this association is causal, TBI may be a risk factor for interpersonal violence, although comparatively few source studies, lack of standardized information about TBI severity, and the inability to investigate potential confounding variables necessarily limit this conclusion.

EPR and optical absorption spectral studies on sphalerite mineral.

The mineral sphalerite (Zn,Fe)S has been characterized by a combination of X-ray diffraction, EPR and NIR spectroscopy. The optical absorption spectrum of mineral sphalerite is due to an iron impurity only, which is in a distorted octahedral environment. The g=2.2 is attributed to iron and g and A value observed in the spectrum 1.999 and 6.0 mT are assigned to Mn(II) impurity in the mineral. These results indicate that iron and Mn(II) impurity have entered the lattice by substitution. The EPR results confirm the presence of manganese in a distorted octahedral environment. It is evident from the chemical analysis that iron is present in higher concentrations. NIR results are due to the presence of water and sulphide fundamentals which also support the formula of the mineral. No sulphate in the sphalerite mineral was observed.

CT colonography: who attends training? A survey of participants at educational workshops.

AIM: To obtain information regarding the demographics of attendees of computed tomography colonography (CTC) training workshops organized by the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), in particular their prior expertise and current practice. MATERIALS AND METHODS: Attendees at five CTC training workshops conducted in Edinburgh (UK), Malmo (Sweden), Amsterdam (Netherlands), Pisa and Stresa (Italy) between February 2007 and April 2010 completed an online questionnaire. Responses were collated and descriptive statistics produced. RESULTS: Three hundred and forty-eight delegates responded; a response rate of 73%. There was wide geographical variability encompassing 20 European member-states and seven countries outside Europe. The overwhelming majority were radiologists (336; 97%). Of the respondents, 299 (86%) were already interpreting CTC in clinical practice but of these, 158 (54%) had no prior formal training in CTC whereas 21 (8%) had attended a previous workshop. Furthermore, of those reporting CTC, 227 (76%) had interpreted fewer than 50 cases. CONCLUSIONS: Despite political imperatives for other groups to interpret CTC, the vast majority of those attending training are radiologists. Worryingly, a significant proportion of these are apparently reporting CTC in clinical practice without adequate training.

Pharmacokinetic differences in exposure to camphor after intraruminal dosing in selectively bred lines of goats.

A pharmacokinetic dosing study with camphor was used to determine whether selection lines of high-juniper-consuming goats (HJC, n = 12) and low-juniper-consuming goats (LJC, n = 12) differed in their respective disposition kinetics. Postdosing plasma camphor concentrations were used to examine whether a timed single blood sample collected after intraruminal administration of camphor would be a useful screening test to aid in the identification of HJC. Yearling female Boer x Spanish goats (n = 24) received a single intraruminal dose of monoterpene cocktail (0.270 g/kg of BW) containing 4 different monoterpenes that represented their composition previously reported for Ashe juniper (Juniperus ashei). Camphor, the predominant monoterpene in Ashe juniper, was 49.6% of the mix and was the monoterpene analyzed for this study. Blood samples were taken at 15 time points from 0 to 8 h after dosing. Concentrations of camphor were measured in plasma using solid phase extraction and gas chromatography/flame-ionization detection analysis. Maximal plasma concentration of camphor was greater for LJC than HJC (P = 0.01), and area under the curve extrapolated to infinity was greater for LJC than HJC (P < 0.01). Total systemic exposure (area under the curve) to camphor was 5 times less in HJC goats. We conclude that 1) HJC goats possess internal mechanisms to reduce the bioavailability of camphor, and 2) a blood sample taken at 45 min or at 60 min after intraruminal administration of camphor may be useful for identifying HJC individual animals from within large populations of goats.

Optical absorption and EPR studies on tenorite mineral.

Optical absorption and EPR studies of the mineral tenorite, a cupric oxide which originated from Mexico and contains 54.40 wt% of CuO. EPR spectral results indicate two Cu(II) closely interacting ions to give a d(2) type structure. The calculated spin Hamiltonian at room temperature and liquid nitrogen temperature is g=2.160 and D=125 G. The intensity of resonance line is not the same in low and high field regions. The optical absorption spectrum is due to Cu(II) in which three sets of energies indicating Cu(II) in two independent tetragonal C(4v) symmetry, in addition to d(2) structure of octahedral coordination. The octahedral and tetragonal field parameters are compared with those reported for several other copper containing minerals.

Investigation of aspiration: milk nasendoscopy versus videofluoroscopy.

Videofluoroscopy has become the gold standard investigation for assessment of aspiration in patients with clinically diagnosed dysphagia due to neurological causes. Modified nasendoscopy has been described for detection of aspiration with varying findings. Milk nasendoscopy is a simple clinic-based technique to evaluate swallow dysfunction, requiring no radiological input. This paper aims to review the correlation of milk nasendoscopy and videofluoroscopy in the detection of aspiration among patients with clinically diagnosed neurological dysphagia. Retrospective notes of 100 patients attending a combined Swallow Clinic for clinically diagnosed aspiration were reviewed. All patients were subjected to both milk nasendoscopy and videofluoroscopy. Correlation of investigation results was reviewed by Kappa test, and difference was statistically examined with Chi square test. Assessment of aspiration in pre-swallow, swallow and post-swallow phases was reviewed using milk nasendoscopy and videofluoroscopy. The significance of difference was measured using Chi square test. Milk nasendoscopy detected post-swallow phase aspiration significantly more than videofluoroscopy with no significant difference in pre-swallow phase, whereas videofluoroscopy was the investigation of choice in detecting aspiration during the swallow phase. In the investigation of clinically diagnosed neurological dysphagia, substantial correlation was seen in detection between videofluoroscopy and milk nasendoscopy. We suggest that milk nasendoscopy should be used as a preliminary clinic-based test thereby reducing the need for investigations requiring radiation doses.