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Whilst many with SARS-CoV-2 infection have mild disease, managed in the community, individuals with cardiovascular risk factors experienced often more severe acute disease, requiring hospitalisation. Increasing concern has also developed over long symptom duration in many individuals, including the majority who managed acutely in the community. Risk factors for long symptom duration, including biological variables, are still poorly defined.We examine post-illness metabolomic and gut-microbiome profiles, in community-dwelling participants with SARS-CoV-2, ranging from asymptomatic illness to Post-COVID Syndrome, and participants with prolonged non-COVID-19 illnesses. We also assess a pre-established metabolomic biomarker score for its association with illness duration.We found an atherogenic-dyslipidaemic metabolic profile, and greater biomarker scores, associated with longer illness, both in individuals with and without SARS-CoV-2 infection. We found no association between illness duration and gut microbiome in convalescence.Findings highlight the potential role of cardiometabolic dysfunction to the experience of long illness duration, including after COVID-19.

SARS-CoV-2 antibody levels can be used to assess humoral immune responses following SARS-CoV-2 infection or vaccination, and may predict risk of future infection. From cross-sectional antibody testing of 9,361 individuals from TwinsUK and ALSPAC UK population-based longitudinal studies (jointly in April-May 2021, and TwinsUK only in November 2021-January 2022), we tested associations between antibody levels following vaccination and: (1) SARS-CoV-2 infection following vaccination(s); (2) health, socio-demographic, SARS-CoV-2 infection and SARS-CoV-2 vaccination variables.Within TwinsUK, single-vaccinated individuals with the lowest 20% of anti-Spike antibody levels at initial testing had 3-fold greater odds of SARS-CoV-2 infection over the next six to nine months, compared to the top 20%. In TwinsUK and ALSPAC, individuals identified as at increased risk of COVID-19 complication through the UK “Shielded Patient List” had consistently greater odds (2 to 4-fold) of having antibody levels in the lowest 10%. Third vaccination increased absolute antibody levels for almost all individuals, and reduced relative disparities compared with earlier vaccinations.These findings quantify the association between antibody level and risk of subsequent infection, and support a policy of triple vaccination for the generation of protective antibodies.Lay summaryIn this study, we analysed blood samples from 9,361 participants from two studies in the UK: an adult twin registry, TwinsUK (4,739 individuals); and the Avon Longitudinal Study of Parents and Children, ALSPAC (4,622 individuals). We did this work as part of the UK Government National Core Studies initiative researching COVID-19. We measured blood antibodies which are specific to SARS-CoV-2 (which causes COVID-19). Having a third COVID-19 vaccination boosted antibody levels. More than 90% of people from TwinsUK had levels after third vaccination that were greater than the average level after second vaccination. Importantly, this was the case even in individuals on the UK “Shielded Patient List”. We found that people with lower antibody levels after first vaccination were more likely to report having COVID-19 later on, compared to people with higher antibody levels. People on the UK “Shielded Patient List”, and individuals who reported that they had poorer general health, were more likely to have lower antibody levels after vaccination. In contrast, people who had had a previous COVID-19 infection were more likely to have higher antibody levels following vaccination compared to people without infection. People receiving the Oxford/AstraZeneca rather than the Pfizer BioNTech vaccine had lower antibody levels after one or two vaccinations. However, after a third vaccination, there was no difference in antibody levels between those who had Oxford/AstraZeneca and Pfizer BioNTech vaccines for their first two doses. These findings support having a third COVID-19 vaccination to boost antibodies.

This study assessed the energy budget for juvenile Atlantic Sea Scallop, Placopecten magellanicus, during a natural drop in temperature (15.6°C to 5.8°C) over an 8-week time period during the fall at three different enrichment levels of carbon dioxide (CO2). Every 2 weeks, individuals were sampled for ecophysiological measurements of feeding activity, respiration rate (RR) and excretion rate (ER) to enable the calculation of scope for growth (SFG) and atomic oxygen:nitrogen ratios (O:N). In addition, 36 individuals per treatment were removed for shell height, dry tissue weight (DTW) and dry shell weight (DSW). We found a significant decrease in feeding rates as CO2 increased. Those rates also were significantly affected by temperature, with highest feeding at 9.4°C. No significant CO2 effect was observed for catabolic energy processes (RR and ER); however, these rates did increase significantly with temperature. The O:N ratio was not significantly affected by CO2, but was significantly affected by temperature. There was a significant interaction between CO2 and temperature for ER and the O:N ratio, with low CO2 levels resulting in a U-shaped response that was not sustained as CO2 levels increased. This suggests that the independent effects of CO2 and temperature observed at low levels are different once a CO2 threshold is reached. Additionally, there were significant differences in growth estimators (shell height and DSW), with the best growth occurring at the lowest CO2 level. In contrast to temperature variations that induced a trade-off response in energy acquisition and expenditure, results from this research support the hypothesis that sea scallops have a limited ability to alter physiological processes to compensate for increasing CO2.

The Atlantic Sea Scallop fishery has grown tremendously over the past twenty years. The location and magnitude of harvestable biomass fluctuates dramatically due to both natural variation and the explicitly spatial management system designed to allow small individuals to grow larger and more valuable. These fluctuations in natural advantages can have profound effects on fishing ports. We use methods from economic growth literature to show that ports with lower initial scallop landings have grown the fastest. Furthermore, good access to biomass influences long-run changes in landings, although this effect exhibits considerable variability across ports. We also find evidence of returns to scope, suggesting that ports with other fishing activities could be well positioned to attract new scalloping activity when stock conditions are favorable. Further investigation of the largest ports using time-series methods also shows a high degree of variability; there are long-run relationships between scallop fishing and harvestable scallop stock in some ports, short-run relationships in some ports, and no relationship between the two in others. We interpret this as evidence that heterogeneity in the natural productivity of the ocean combined with explicitly spatial fisheries management has induced a spatial component to the port-level response to changes in biomass availability.

A dynamic energy budget (DEB) model integrating pCO

Background: Twins offer social scientists a unique opportunity to understand the interplay of social factors and physical and mental well-being. TwinsUK is the largest UK registry of adult mono- and dy-zygotic twins, but most of the research that utilises the cohorts’ data to date has focused on the genetic underpinnings of complex disease. Methods: Following formal unstructured discussions with social scientists we identified key areas of research interest and annotated the historical data collections in TwinsUK where they could be applied to these research aims. Results: We present a summary of variables identified as of key interest to researchers from the social science sphere, spanning the following domains: 1: Parenting, child rearing and pregnancies; 2: Working habits and patterns; 3: Sleeping habits and patterns; 4: Social support; 5: Negative life events; 6: Spousal relationships. Conclusions: TwinsUK has a wide range of genetic and health data that would allow investigation of research questions focusing on these domains.

This review focuses on two books published in 2014 by James A. Forte, professor of social work at Salisbury University, Maryland, USA. While there is no explicit mention made by the author of these...

© 2019 American Society of Human Genetics The occurrence of non-epileptic hyperkinetic movements in the context of developmental epileptic encephalopathies is an increasingly recognized phenomenon. Identification of causative mutations provides an important insight into common pathogenic mechanisms that cause both seizures and abnormal motor control. We report bi-allelic loss-of-function CACNA1B variants in six children from three unrelated families whose affected members present with a complex and progressive neurological syndrome. All affected individuals presented with epileptic encephalopathy, severe neurodevelopmental delay (often with regression), and a hyperkinetic movement disorder. Additional neurological features included postnatal microcephaly and hypotonia. Five children died in childhood or adolescence (mean age of death: 9 years), mainly as a result of secondary respiratory complications. CACNA1B encodes the pore-forming subunit of the pre-synaptic neuronal voltage-gated calcium channel Cav2.2/N-type, crucial for SNARE-mediated neurotransmission, particularly in the early postnatal period. Bi-allelic loss-of-function variants in CACNA1B are predicted to cause disruption of Ca2+ influx, leading to impaired synaptic neurotransmission. The resultant effect on neuronal function is likely to be important in the development of involuntary movements and epilepsy. Overall, our findings provide further evidence for the key role of Cav2.2 in normal human neurodevelopment.

OBJECTIVE: The movement disorders acute dystonia, akathisia, Parkinsonian symptoms and tardive dyskinesia [extrapyramidal side effects (EPSs)] are recognized adverse effects of antipsychotic medication. Previous studies have indicated that substance abuse in patients with schizophrenia can worsen EPS. This study therefore investigated the relationship between drug and alcohol use and EPS in a group of patients with schizophrenia. METHODS: Seventy patients with schizophrenia assessed for drug and alcohol use, global functioning, EPS and suicidality. Chlorpromazine equivalents were correlated to levels of EPS and substance abuse. RESULTS: Current EPS were found in 65% of the sample despite three-quarters of the patients receiving second-generation antipsychotics. An even higher level of patients, 87%, was found to have a history of EPS. A long history of schizophrenia independently predicted presence of any EPS, particularly akathisia, controlling for history of substance abuse which was a non-significant predictor. CONCLUSIONS: History or current use of alcohol or drug abuse did not predict EPS, except for alcohol abuse at the time of diagnosis which was associated with current akathisia. Length of illness was correlated with EPS, whereas suicidality was not linked to akathisia. Neither chlorpromazine equivalent antipsychotic dose nor whether the patient received first-generation or second-generation antipsychotic medication was significantly associated with EPS or substance abuse. Copyright © 2013 John Wiley & Sons, Ltd.

The analysis of rich catalogues of genetic variation from population-based sequencing provides an opportunity to screen for functional effects. Here we report a rare variant in APOC3 (rs138326449-A, minor allele frequency ~0.25% (UK)) associated with plasma triglyceride (TG) levels (−1.43 s.d. (s.e.=0.27 per minor allele (P-value=8.0 × 10−8)) discovered in 3,202 individuals with low read-depth, whole-genome sequence. We replicate this in 12,831 participants from five additional samples of Northern and Southern European origin (−1.0 s.d. (s.e.=0.173), P-value=7.32 × 10−9). This is consistent with an effect between 0.5 and 1.5 mmol l−1 dependent on population. We show that a single predicted splice donor variant is responsible for association signals and is independent of known common variants. Analyses suggest an independent relationship between rs138326449 and high-density lipoprotein (HDL) levels. This represents one of the first examples of a rare, large effect variant identified from whole-genome sequencing at a population scale., Population-based genome sequencing provides an increasingly rich resource for the identification of low-frequency, large effect variants associated with clinically important phenotypes. Timpson et al. use UK10K data to identify a variant of the APOC3 gene strongly associated with plasma triglyceride levels.

Aims and MethodTo describe the development of public education materials provided by the Royal College of Psychiatrists in the ‘Help is at Hand’ series of leaflets, and to assess the acceptability and usefulness of information about mental health on the College website by analysis of the online responses of those accessing this information.ResultsMore than 4000 responses to 14 of the ‘Help is at Hand’ leaflets were analysed. Ratings were generally high, with the exception of the statement ‘This leaflet talks down to me’. Free text responses were generally positive.Clinical ImplicationsThe College website is an accessible source of high-quality mental health information of the sort demanded by both service users and current health policy.

Aims and MethodTo investigate the attitudes that psychiatrists hold towards people with mental illness. Each member of the Royal College of Psychiatrists in the UK was sent a questionnaire based on previous research in this area, supplemented with relevant questions on management.Results2813 of 6524 questionnaires were returned (43%). Psychiatrists' attitudes compared favourably with those of the general population. Among other findings, they believed that the risk of dangerousness was overemphasised, that misdiagnosis of schizophrenia in Black people is common, and that polypharmacy and the use of antipsychotic medication above British National Formulary levels occurs too often.Clinical ImplicationsPsychiatrists' attitudes are substantially more favourable towards people with mental illness than those of the general population with individual, but important, exceptions. Some aspects of psychiatric management, especially of antipsychotic medication, may undermine this, however. Comparison with other groups, e.g. general practitioners, nurses and social workers, would be useful in planning how to reduce the stigmatisation of people with mental illness.

In autumn 1996, under the Presidency of Dr Robert Kendell, the College decided to mount a campaign to tackle the stigmatisation of people with mental illnesses. In 1997, a working party proposed goals, content, process and a 5-year governance. Other campaigns, both here and abroad, have either generically addressed ‘mental health problems' (e.g. Mind's ‘Respect’ Campaign) or targeted a specific mental illness, e.g. the World Psychiatric Association's anti-stigma campaign in respect of people with schizophrenia. Our working party decided that it might be timely to recognise the differences in public attitudes to the variety of mental illnesses. The campaign thus addressed six categories of mental illness: anxiety disorders, depressive disorders, schizophrenia, the dementias, eating disorders, and drug and alcohol misuse/addiction. Target populations were identified as doctors, children and adolescents, the workplace, the media and the general public. The working party had also secured funding and arranged for a survey, in July 1998, by the Office for National Statistics of opinions of the British public concerning people with these mental illnesses (Crisp et al, 2000). The Campaign started on 7 October 1998. Since that time, and drawing upon our survey findings within its initial literature review (Kelly, 1999) the Department of Health mounted its own anti-stigma campaign, ‘Mind Out for Mental Health’, which addressed a similar range of mental illnesses.

There is a long and varied usage of self-help housing policy in South Africa, dating from colonial times when Africans were dumped in locations and left to build their own housing, to the present post apartheid reconstruction. The paper documents and periodises the adoption of self-help strategies for housing the African population of South African cities throughout the 20th century. Exploration of the practice of self-help housing practices in Johannesburg suggests that owner construction is a prevailing method of social engineering, whose acceptance or rejection reflects perceived political and economic advantages for the state and the private sector, and is not a simple response to a shortage of affordable shelter among the poor.

BackgroundAims of the Defeat Depression Campaign between 1991 and 1996 included the reduction of stigma associated with depression, education of the public about the disorder and its treatment and encouragement of earlier treatment-seeking. Newspaper and magazine articles, radio and television programmes and other media activities were employed.MethodSurveys of public attitudes were conducted by MORI in late 1991, early 1995 and mid-1997. Each covered approximately 2000 subjects, sampled to be representative of the population of Great Britain. Structured interviews covered views on depression, treatment and general practitioners (GPs).ResultsThere were significant positive changes regarding attitudes to depression, reported experience of it, attitudes to antidepressants, and less consistently, to treatment from GPs. Changes were of the order of 5–10%. Throughout, attitudes to depression and to treatment by counselling were very favourable, whereas antidepressants were regarded as addictive and less effective.ConclusionsPositive attitude change was achieved during the Campaign, although there is still room for improvement in some aspects.

The movement disorders acute dystonia, akathisia, Parkinsonian symptoms and tardive dyskinesia [extrapyramidal side effects (EPSs)] are recognized adverse effects of antipsychotic medication. Previous studies have indicated that substance abuse in patients with schizophrenia can worsen EPS. This study therefore investigated the relationship between drug and alcohol use and EPS in a group of patients with schizophrenia.Seventy patients with schizophrenia assessed for drug and alcohol use, global functioning, EPS and suicidality. Chlorpromazine equivalents were correlated to levels of EPS and substance abuse.Current EPS were found in 65% of the sample despite three-quarters of the patients receiving second-generation antipsychotics. An even higher level of patients, 87%, was found to have a history of EPS. A long history of schizophrenia independently predicted presence of any EPS, particularly akathisia, controlling for history of substance abuse which was a non-significant predictor.History or current use of alcohol or drug abuse did not predict EPS, except for alcohol abuse at the time of diagnosis which was associated with current akathisia. Length of illness was correlated with EPS, whereas suicidality was not linked to akathisia. Neither chlorpromazine equivalent antipsychotic dose nor whether the patient received first-generation or second-generation antipsychotic medication was significantly associated with EPS or substance abuse.

The current upsurge in environmental problems within society has created a new set of forces which impact upon industry. On the one hand, the development of 'green issues' can be seen as a constraint on unfettered industrial production; whilst a more optimistic view would see such forces as an opportunity and potential driving force for sustained competitive advantage. The latter is certainly the case if industry and commerce can be made to change their core values and to accept a long-term .view on their investment rather than the short-termism that has characterized the past decade. Central to this change in values is the role of business education, for it is only through a sustained development of the intellectual base of management that we can hope to make meaningful changes to business practice. The aim of this paper is to explore the implications for management education inherent within the 'green challenge' by reference to the experience in UK business schools. The argument focuses around the view that if we want to change the values of management we should endeavour to change the way managers are educated.

On 12th December 1995 the Royal College of Psychiatrists launched the ‘Help is at Hand’ leaflet entitled Social Phobias. In an attempt to gauge its success and distribution an audit was performed on the number of leaflets requested from the College between December 1995 and December 1996. Between those dates approximately 37,500 leaflets were distributed, 10,138 to varying organisations and approximately 27,360 to members of the public. From the total distribution the launch of the leaflet appears to have been successful. Unfortunately little is known about the value of information provided to organisations or individuals requesting the leaflet. More feedback is needed regarding the distribution and effectiveness of public education leaflets to ensure that the appropriate groups are effectively targeted.

Summary The Royal College of Psychiatrists9 is receiving more positive press coverage than negative, which is the reverse for ‘psychiatry’ in general. The use of stigmatising language was made in only a very small number of instances. Regional newspapers tended to reflect the most substantial negativity in coverage. Most areas of negativity were in relation either to ‘community care’ or changes/potential changes to law or policy, primarily Government policy. 1997 saw a decrease in the coverage of the College9s public education materials compared to 1993, although the coverage was consistent throughout the year. Overall coverage of psychiatric issues was on the increase. The most negative comments in terms of ‘treatment’ and ‘diagnosis’ were concerned with electroconvulsive therapy and chronic fatigue syndrome.

The Department of Energy has set forth a proposal to use an Alternative Landfill Design (ALD) for the Mixed Low Level Waste disposal facility, in Area 5 of the Nevada Test Site in place of a traditional engineered liner for the facility. The purpose of this thesis is to examine the impasse between the DOE and the State of Nevada regarding the proposal of placing a traditional liner versus the alternative landfill design, using a case study method to provide recommendations to policy makers and the NTS CAB. This project used secondary data to evaluate, and determine the effectiveness of the ALD.

Bullying can be fatal. Up to 16 children in the UK kill themselves every year as a result of bullying. Bullying occurs in every school and affects many adults in the workplace. According to some, it is a fact of life in international politics. Whether on the world stage or in the schoolyard

My first encounter with the media was about 17 years ago when Marjorie Wallace turned up at a College meeting. As the conference organiser, I was told by the then secretary of the College, Natalie Cobbing, to ensure that Marjorie was not admitted, as our meetings were closed to the press. In fact, the fear of God was instilled in the staff at that time about the press – no staff were to talk to the media. Disobedience could be seen as a sackable offence. Ironically, Marjorie Wallace is now an Honorary Fellow of the College in recognition of the work she has done in mental health, both as a journalist and campaigner.

In October 1998, the Royal College of Psychiatrists launched a new five-year campaign entitled ‘Changing Minds: Every Family in the Land’, which aims to tackle the problems of stigmatisation of and discrimination against people with mental disorders. As part of the campaign, the College recently sent to the membership a ‘Declaration of Intent’, asking members to sign up to the Campaign's aims and to indicate their support for it. To date we have received more than 2000 signatures and would like to encourage all readers of the Bulletin to return their forms immediately. If you have lost your declaration form please contact the External Affairs Department.

(a) to increase public and professional under standing of six mental disorders (anxiety, depression, schizophrenia, alcohol and drug misuse, dementia and eating dis orders): (b) to reduce the stigma and discrimination against people suffering from these dis orders; and (c) to close the gap between the different beliefs of health care professionals and the public about useful treatments and intervention.

We would fully support Raj Persaud's contention that “psychiatry is a complex enterprise”. Having been involved in the setting up and development of the College's press office over the last 12 years, we are still sometimes surprised at how complicated and unexpected some psychiatric issues are