This report from the International Consortium on Hallucinations Research considers the current status and future directions in research on psychological therapies targeting auditory hallucinations ...(hearing voices). Therapy approaches have evolved from behavioral and coping-focused interventions, through formulation-driven interventions using methods from cognitive therapy, to a number of contemporary developments. Recent developments include the application of acceptance- and mindfulness-based approaches, and consolidation of methods for working with connections between voices and views of self, others, relationships and personal history. In this article, we discuss the development of therapies for voices and review the empirical findings. This review shows that psychological therapies are broadly effective for people with positive symptoms, but that more research is required to understand the specific application of therapies to voices. Six key research directions are identified: (1) moving beyond the focus on overall efficacy to understand specific therapeutic processes targeting voices, (2) better targeting psychological processes associated with voices such as trauma, cognitive mechanisms, and personal recovery, (3) more focused measurement of the intended outcomes of therapy, (4) understanding individual differences among voice hearers, (5) extending beyond a focus on voices and schizophrenia into other populations and sensory modalities, and (6) shaping interventions for service implementation.
Background
The global food system faces incessant and complex challenges of providing food for a growing population while remaining within planetary boundaries. Agriculture and food production ...depletes finite resources such as land, water and fossil fuels, and contributes to climate change. GHG emissions occur at every stage in the life cycle of a food from primary production through to processing, packaging, distribution, consumption, and waste. This results in approximately 34% of anthropogenic GHGEs globally. Thus, the aim of this study is to determine the levels of and contributors to dietary carbon footprint among older Irish adults.
Methods
Diet quality metrics explore associations between dietary patterns and health outcomes. A Food Frequency Questionnaire was used to assess dietary intake of participants in the Mitchelstown Cohort Study. To determine carbon footprint, foods were linked to CO2eq emission factors from life cycle assessment studies. The DASH and Mediterranean diet scores were used to determine if higher adherence to these recommended diets was associated with improved health outcomes and lower dietary GHGEs.
Results
Preliminary results suggest that the daily CO2eq is similar to a previous Irish study, which found that the daily dietary intake was 6.5 kg of CO2eq per person. As expected, consumption of red meat was the highest contributor to dietary carbon footprint. Fruit and vegetable consumption was low despite these foods having a lower carbon footprint.
Conclusions
The environmental impacts of current dietary patterns are substantial, threatening ecological integrity. Greater adherence to well-characterized diets has been associated with lower diet-related GHGE. Transforming our diets is required to build a resilient and sustainable food system, while safeguarding planetary health. However, nutrition and long-term health must remain a key component of any dietary change particularly in vulnerable and nutritionally compromised populations.
Key messages
Food systems and diets thereof are inextricably linked with nutrition, health and environmental issues. Dietary transitions are needed to reduce global burden of disease and environmental degradation.
Consideration on the feasibility of adopting sustainable diets among older populations to ensure healthy ageing is required. Trade-offs arise between protein requirements and environmental impacts.
A whole-genome radiation hybrid (RH) panel was used to construct a high-resolution map of the rat genome based on microsatellite and gene markers. These include 3,019 new microsatellite markers ...described here for the first time and 1,714 microsatellite markers with known genetic locations, allowing comparison and integration of maps from different sources. A robust RH framework map containing 1,030 positions ordered with odds of at least 1,000:1 has been defined as a tool for mapping these markers, and for future RH mapping in the rat. More than 500 genes which have been mapped in mouse and/or human were localized with respect to the rat RH framework, allowing the construction of detailed rat-mouse and rat-human comparative maps and illustrating the power of the RH approach for comparative mapping.
Tranilast (N-(3'4'-demethoxycinnamoyl)-anthranilic acid (N-5)) is an investigational drug for the prevention of restenosis following percutaneous transluminal coronary revascularization. An increase ...in bilirubin levels was observed in 12% of patients upon administration of tranilast in a phase III clinical trial. To identify the potential genetic factors that may account for the drug-induced hyperbilirubinemia, we examined polymorphisms in the uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) gene in over a thousand patients. Our results suggested that the TA repeat polymorphism in UGT1A1, which predisposes some individuals to Gilbert's syndrome, predicted the susceptibility to tranilast-induced hyperbilirubinemia. The (TA)(7)/(TA)(7) genotype was present in 39% of the 127 hyperbilirubinemic patients vs 7% of the 909 controls (P=2 x 10(-22)). Rapid identification of genetic factors accounting for the observed adverse effect during the course of a double-blind clinical trial demonstrated the potential application of pharmacogenetics in the clinical development of safe and effective medicines.
Fasting glucose and insulin are intermediate traits for type 2 diabetes. Here we explore the role of coding variation on these traits by analysis of variants on the HumanExome BeadChip in 60,564 ...non-diabetic individuals and in 16,491 T2D cases and 81,877 controls. We identify a novel association of a low-frequency nonsynonymous SNV in GLP1R (A316T; rs10305492; MAF=1.4%) with lower FG (β=-0.09±0.01 mmol l(-1), P=3.4 × 10(-12)), T2D risk (OR95%CI=0.860.76-0.96, P=0.010), early insulin secretion (β=-0.07±0.035 pmolinsulin mmolglucose(-1), P=0.048), but higher 2-h glucose (β=0.16±0.05 mmol l(-1), P=4.3 × 10(-4)). We identify a gene-based association with FG at G6PC2 (pSKAT=6.8 × 10(-6)) driven by four rare protein-coding SNVs (H177Y, Y207S, R283X and S324P). We identify rs651007 (MAF=20%) in the first intron of ABO at the putative promoter of an antisense lncRNA, associating with higher FG (β=0.02±0.004 mmol l(-1), P=1.3 × 10(-8)). Our approach identifies novel coding variant associations and extends the allelic spectrum of variation underlying diabetes-related quantitative traits and T2D susceptibility.
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•X-ray scattering experiments were performed on DMPC with and without halothane.•Molecular dynamics simulations were performed on similar systems.•Halothane causes an increase in DMPC ...chain spacing.•Pressure causes a reduction in DMPC chain spacing.
Using a combination of high pressure wide angle X-ray scattering experiments and molecular dynamics simulations, we probe the effect of the archetypal general anaesthetic halothane on the lipid hydrocarbon chain packing and ordering in model bilayers and the variation in these parameters with pressure. Incorporation of halothane into the membrane causes an expansion of the lipid hydrocarbon chain packing at all pressures. The effect of halothane incorporation on the hydrocarbon chain order parameter is significantly reduced at elevated pressure.
STUDY QUESTION
Do women with a previous miscarriage or termination of pregnancy have an increased risk of spontaneous preterm birth and is this related to previous cervical dilatation and curettage?
...SUMMARY ANSWER
A single previous pregnancy loss (termination or miscarriage) managed by cervical dilatation and curettage is associated with a greater risk of SpPTB.
WHAT IS KNOWN ALREADY
Miscarriage affects ∼20% of pregnancies and as many as a further 20% of pregnancies undergo termination.
STUDY DESIGN, SIZE, DURATION
We utilized data from 5575 healthy nulliparous women with singleton pregnancies recruited to the Screening for Pregnancy Endpoints (SCOPE) study, a prospective cohort study performed between November 2004 and January 2011.
PARTICIPANTS/MATERIALS, SETTING, METHODS
The primary outcome was spontaneous preterm birth (defined as spontaneous preterm labour or preterm premature rupture of membranes (PPROM) resulting in preterm birth <37 weeks' gestation). Secondary outcomes included PPROM, small for gestational age, birthweight, pre-eclampsia and placental abruption.
MAIN RESULTS AND THE ROLE OF CHANCE
Women with previous pregnancy loss (miscarriage or termination) were compared with those with no previous pregnancy loss. There were 4331 (78%) women who had no previous pregnancy loss, 974 (17.5%) who had one early previous pregnancy loss, 249 (4.5%) who had two and 21 (0.5%) who had three or four losses. Women with two to four previous losses, but not those with a single loss, had an increased risk of spontaneous preterm birth (adjusted OR 2.12; 95% CI 1.55, 2.90) and/or placental abruption (adjusted OR 2.30; 95% CI 1.36, 3.89) compared with those with no previous pregnancy. A single previous miscarriage or termination of pregnancy where the management involved cervical dilatation and curettage was associated with an increased risk of spontaneous preterm birth (adjusted OR 1.64; 95% CI 1.08, 2.50; 6% absolute risk and adjusted OR 1.83; 95% CI 1.35, 2.48; 7% absolute risk, respectively) compared with those with no previous pregnancy losses. This is in contrast with women with a single previous miscarriage or termination managed non-surgically who showed no increase risk (adjusted OR 0.86; 95% CI 0.38, 1.94; 3.4% absolute risk and adjusted OR 0.87; 95% CI 0.69, 1.12; 3.8% absolute risk, respectively).
LIMITATIONS, REASONS FOR CAUTION
Although every effort was made to record accurate previous pregnancy data, it was not feasible to confirm the history and management of previous pregnancy loss by hospital records. This may have introduced recall bias.
WIDER IMPLICATIONS OF THE FINDINGS
This large prospective cohort study of healthy nulliparous women has demonstrated that women with either a previous miscarriage or termination of pregnancy were at increased risk of spontaneous preterm birth if they were managed by procedures involving cervical dilatation and curettage. However, overall, women with a single pregnancy loss did not have an increased risk of having any other of the adverse pregnancy outcomes examined. In contrast, two to four previous pregnancy losses were associated with an increased risk of having a pregnancy complicated by spontaneous preterm birth and/or placental abruption. Research is required to determine whether non-surgical management of miscarriage or termination of pregnancy should be advocated over surgical treatment.
STUDY FUNDING/COMPETING INTEREST(S)
New Zealand: New Enterprise Research Fund, Foundation for Research Science and Technology; Health Research Council; Evelyn Bond Fund, Auckland District Health Board Charitable Trust.
Australia: Premier's Science and Research Fund, South Australian Government.
Ireland: Health Research Board.
Leeds: Cerebra Charity, Carmarthen.
Manchester: National Health Service NEAT Grant; Manchester Biotechnology and Biological Sciences Research Council; University of Manchester Proof of Concept Funding.
King's College London: Guy's and St Thomas' Charity.
King's College London and Manchester: Tommy's—The Baby Charity.
TRIAL REGISTRATION NUMBER
N/A.
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