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INTRODUCTION: Substance use disorders (SUD) and associated problems are highly prevalent but often undetected in patients with Severe Mental Illness (SMI). This study investigates the prevalence, under-detection, and variables associated with a high risk of SUD in a Dutch sample of adult outpatient SMI patients (N = 83). METHODS: Substance use (The Tobacco, Alcohol, Prescription medication, and other Substance use -TAPS-tool), quality of life (Manchester Short Assessment of Quality of Life-MANSA), general functioning (Health of the Nation Outcome Scale-HoNOS), DSM-5 classifications and patient characteristics (age, education, marital status) were assessed. Detection of SUD was determined by calculating % agreement of DSM-5 classification to TAPS outcome. A logistic regression analysis was performed to determine the association of patient characteristics, quality of life and general functioning to an increased risk of SUD as determined by the TAPS. RESULTS: Concerning prevalence, 89% of the patients used tobacco, above guideline-recommended daily limits of alcohol, illicit drugs or prescription medications for nonmedical purposes. Almost all smokers, half of the alcohol users and three-quarter of the patients that use marihuana or stimulant drugs had a high risk of SUD. All patients with high risk of SUD associated with alcohol, drugs or medications also had SUD associated with tobacco use. Concerning under detection less than half of the patients with a high risk of SUD according the TAPS had a SUD in their DSM-5 classification. Gender, partner, age and satisfaction about the relationship with family had a significant association with a high risk of SUD. CONCLUSIONS: Screening for addiction in an SMI sample with the TAPS-tool revealed a high prevalence of substance use and a high risk of SUD. TAPS outcomes compared to the clinically obtained DSM-5 classification revealed a high degree of under-detection of substance use problems. Smoking seems to pose a specific additional risk of addiction and deserves more attention in treatment to achieve greater health care benefits.
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Transtornos Mentais , Qualidade de Vida , Transtornos Relacionados ao Uso de Substâncias , Humanos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Transtornos Mentais/epidemiologia , Transtornos Mentais/diagnóstico , Prevalência , Países Baixos/epidemiologiaRESUMO
BACKGROUND: Elucidating the influence of mild intellectual disability (MID; IQ 50-70)/borderline intellectual functioning (BIF; IQ 70-85) and (comorbid) post-traumatic stress disorder (PTSD) on the quality of life of patients with serious mental illness (SMI) could improve their mental health care. METHOD: This study comprises a prospective longitudinal cohort study using routine outcome monitoring data. The cohort comprised 601 patients who had undertaken at least one Manchester Short Assessment of Quality of Life (MANSA). The scores for screeners to detect MID/BIF and PTSD were analysed, and a repeated measures analysis of variance and a multi-level linear regression was performed on the MANSA scores. RESULTS: The average quality of life for all patient groups increased significantly over time. A between-subject effect on quality of life was observed for PTSD, but not MID/BIF. CONCLUSIONS: PTSD but not MID/BIF is associated with a lesser quality of life over time.
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Deficiência Intelectual , Transtornos de Estresse Pós-Traumáticos , Humanos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Deficiência Intelectual/diagnóstico , Pacientes Ambulatoriais , Qualidade de Vida , Estudos Longitudinais , Estudos Prospectivos , Índice de Gravidade de DoençaRESUMO
PURPOSE: The Brief Negative Symptom Scale (BNSS) was developed to measure negative symptoms of schizophrenia. However, the Dutch translation of this instrument, called the "Korte Schaal voor Negatieve Symptomen" (KSNS), has not yet been validated. This study investigates the validity and reliability of this Dutch version of the instrument. PATIENTS AND METHODS: The Psychotic Symptom Rating Scale (PSYRATS), Calgary Depression Scale for Schizophrenia (CDSS), the Health of the Nation Scale (HoNOS) and the KSNS were used for routine outcome monitoring to measure symptoms in 28 patients with a psychotic disorder who were being treated on a long-stay ward. RESULTS: The internal consistency of the KSNS is fair to good. The inter-rater reliability is excellent. The concurrent validity is moderate but acceptable. The correlations between the KSNS and scales for depression and positive symptoms were not significant, which indicate good divergent validity. CONCLUSION: Despite the small sample size of the current study, we conclude that the BNSS, called the KSNS in Dutch, appears to be a reliable and valid tool for investigating negative symptoms in detail in patients with psychotic disorders.
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Functional traits are proxies for plant physiology and performance, which do not only differ between species but also within species. In this work, we hypothesized that (a) with increasing precipitation, the percentage of focal species which significantly respond to changes in grazing intensity increases, while under dry conditions, climate-induced stress is so high that plant species hardly respond to any changes in grazing intensity and that (b) the magnitude with which species change their trait values in response to grazing, reflected by coefficients of variation (CVs), increases with increasing precipitation. Chosen plant traits were canopy height, plant width, specific leaf area (SLA), chlorophyll fluorescence, performance index, stomatal pore area index (SPI), and individual aboveground biomass of 15 species along a precipitation gradient with different grazing intensities in Mongolian rangelands. We used linear models for each trait to assess whether the percentage of species that respond to grazing changes along the precipitation gradient. To test the second hypothesis, we assessed the magnitude of intraspecific trait variability (ITV) response to grazing, per species, trait, and precipitation level by calculating CVs across the different grazing intensities. ITV was most prominent for SLA and SPI under highest precipitation, confirming our first hypothesis. Accordingly, CVs of canopy height, SPI, and SLA increased with increasing precipitation, partly confirming our second hypothesis. CVs of the species over all traits increased with increasing precipitation only for three species. This study shows that it remains challenging to predict how plant performance will shift under changing environmental conditions based on their traits alone. In this context, the implications for the use of community-weighted mean trait values are discussed, as not only species abundances change in response to changing environmental conditions, but also values of traits considerably change. Including this aspect in further studies will improve our understanding of processes acting within and among communities.
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BACKGROUND: The reliability and validity of the Screener for Intelligence and Learning Disabilities (SCIL) are unknown in a population of outpatients with severe mental illness. The prevalence of mild or borderline intellectual disabilities (MBID); an umbrella term for people with borderline intellectual functioning (BIF) and mild intellectual disability (MID) in this population is also unknown. METHODS: A total of 625 patients were screened with the SCIL, 201 of which also had IQ test results. RESULTS: Cronbach's alpha of the SCIL was 0.73. The AUC value for detecting MBID was 0.81, and also 0.81 for detecting MID, with percentages of correctly classified subjects (when using the advised cut-off scores) being 73% and 79%, respectively. The SCIL results suggested that 40% of the patients were suspected of MBID and 20% of MID. CONCLUSION: The SCIL seems to be an appropriate screening tool for MBID. It is important to screen for MBID because a substantial proportion of outpatients with severe mental illness appear to be functioning at this level. It is necessary to adapt treatment for these patients.
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Deficiência Intelectual/diagnóstico , Deficiências da Aprendizagem/diagnóstico , Transtornos Mentais , Testes Neuropsicológicos/normas , Pacientes Ambulatoriais/estatística & dados numéricos , Adulto , Idoso , Comorbidade , Feminino , Humanos , Deficiência Intelectual/epidemiologia , Deficiências da Aprendizagem/epidemiologia , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Escalas de Wechsler , Adulto JovemRESUMO
A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has not been fixed in the paper.
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Herbivory and disturbance are major drivers of biological invasions, but it is unclear how they interact to determine exotic vs. native seedling recruitment and what consequences arise for biodiversity and ecosystem functioning. Previous studies neglected the roles of different, potentially interacting, guilds of generalist herbivores such as rodents and gastropods. We therefore set up a full-factorial rodent exclusion x gastropod exclusion x disturbance x seed-addition experiment in a grassland community in Central Germany and measured early seedling recruitment, as well as species richness, species composition and aboveground biomass. Gastropod herbivory reduced the positive effect of disturbance on seedling recruitment, particularly for exotic species. Rodent herbivory had weak positive effects on seedling recruitment at undisturbed sites, irrespective of species origin. This effect was likely driven by their strong negative effect on productivity. Interactive effects between both herbivore guilds became only evident for species richness and composition. How many species established themselves depended on disturbance, but was independent of species origin. The fewer exotic species that established themselves increased productivity to a stronger extent compared to native species. Our study highlights that joint effects of disturbance, herbivory and species origin shape early recruitment, while they only weakly affect biodiversity and ecosystem functioning.
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Living organisms are constrained by both resource quantity and quality. Ecological stoichiometry offers important insights into how the elemental composition of resources affects their consumers. If resource quality decreases, consumers can respond by shifting their body stoichiometry, avoiding low-quality resources, or up-regulating feeding rates to maintain the supply of required elements while excreting excess carbon (i.e., compensatory feeding). We analyzed multitrophic consumer body stoichiometry, biomass, and feeding rates along a resource-quality gradient in the litter of tropical forest and rubber and oil-palm plantations. Specifically, we calculated macroinvertebrate feeding rates based on consumer metabolic demand and assimilation efficiency. Using linear mixed effects models, we assessed resource-quality effects on macroinvertebrate detritivore and predator communities. We did not detect shifts in consumer body stoichiometry or decreases in consumer biomass in response to declining resource quality, as indicated by increasing carbon-to-nitrogen ratios. However, across trophic levels, we found a strong indication of decreasing resource quality leading to increased consumer feeding rates through altered assimilation efficiency and community body size structure. Our study reveals the influence of resource quality on multitrophic consumer feeding rates and suggests compensatory feeding to be more common across consumer trophic levels than was formerly known.
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Invertebrados , Nitrogênio , Animais , Biomassa , Carbono , Ecologia , Cadeia AlimentarRESUMO
1. Model analyses show that the stability of population dynamics and food web persistence increase with the strength of interference competition. Despite this critical importance for community stability, little is known about how external factors such as the environmental temperature affect intraspecific interference competition. 2. We aimed to fill this void by studying the functional responses of two ground beetle species of different body size, Pterostichus melanarius and Poecilus versicolor. These functional response experiments were replicated across four predator densities and two temperatures to address the impact of temperature on intraspecific interference competition. 3. We generally expected that warming should increase the speed of movement, encounter rates and in consequence interference among predator individuals. In our experiment, this expectation was supported by the results obtained for the larger predator, P. melanarius, whereas the opposite pattern characterized the interference behaviour of the smaller predator P. versicolor. 4. These results suggest potentially nontrivial implications for the effects of environmental temperature on intraspecific interference competition, for which we propose an explanation based on the different sensitivity to warming of metabolic rates of both species. As expected, increasing temperature led to stronger interference competition of the larger species, P. melanarius, which exhibited a weaker increase in metabolic rate with increasing temperature. The stronger increase in the metabolic rate of the smaller predator, P. versicolor, had to be compensated by increasing searching activity for prey, which did not leave time for increasing interference. 5. Together, these results suggest that any generalization how interference competition responds to warming should also take the species' metabolic response to temperature increases into account.
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Tamanho Corporal/fisiologia , Besouros/fisiologia , Metabolismo Energético/fisiologia , Temperatura , Animais , Densidade Demográfica , Comportamento Predatório/fisiologiaRESUMO
BACKGROUND: Radiotherapy plays an important role in the treatment of basal cell carcinoma of the face and head and achieves cure rates of 92-96 %. Different fractionation concepts of radiotherapy have been described. This study investigates the efficacy, as well as acute and chronic toxicity, of a slightly hypo-fractionated radiotherapy schedule. PATIENTS AND METHODS: 85 patients with 104 tumors underwent radiotherapy for basal cell carcinoma of the face and head. The radiotherapy schedule was 5 x 3 Gray/week up to a total dose of 57 Gray in 95 % of patients. Acute and late radiotherapy toxicity and cosmetic outcome were evaluated in long-term follow-up. RESULTS: No recurrence was observed. In 87 % of tumors, only low acute toxicity occurred at the end of radiotherapy. Late toxicity, if observed, was low in most patients. "Excellent" or "good" cosmesis was achieved in 94 % of tumors at last follow-up. CONCLUSIONS: Our radiotherapy schedule achieves a very high local control rate and very good cosmetic and functional results. This fractionation can be recommended as a standardized radiotherapy treatment for basal cell carcinoma of the face and head.
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Carcinoma Basocelular/radioterapia , Neoplasias Faciais/radioterapia , Neoplasias de Cabeça e Pescoço/radioterapia , Neoplasias Cutâneas/radioterapia , Idoso , Idoso de 80 Anos ou mais , Fracionamento da Dose de Radiação , Relação Dose-Resposta à Radiação , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Radiodermite/etiologiaRESUMO
This study tested the theory that advances on theory-of-mind tasks and on executive function tasks show a strong correlation because the typically used theory-of-mind tasks pose the same executive demands. In Experiment 1 with fifty-six 3- to 6-year-old children, performance on the dimensional change card-sorting task as an executive function task was correlated with performance on the usual false-belief prediction task, r = .65, and the false-belief explanation task, r = .65, as measures of theory-of-mind development. Because the explanation version of the false-belief test is supposed to be free of the alleged executive demands inherent in the prediction version, the equally strong correlation with the executive function task suggests that this correlation cannot be due to common executive demands. In Experiment 2, the basic finding of Experiment 1 was replicated on another sample of 73 children, ages 3 to 5.5 years. The need for new theories to explain the developmental link between theory of mind and executive function development is discussed, and some existing candidates are evaluated.