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Staphylococcus aureus is associated with significant mortality and increased burden on the healthcare system. Relatively few reliable estimates are available regarding the impact of meticillin-resistant S. aureus (MRSA) infection compared with meticillin-susceptible S. aureus (MSSA) infection.To compare patients with MRSA infection and MSSA infection to identify differences in inpatient mortality, length of stay and costs of hospital services, and identify predictors of MRSA as a cause of S. aureus infection.An analytical, retrospective, longitudinal study using non-identifiable linked data on adults admitted to hospitals of a health district in Australia with a diagnosis of S. aureus infection over a 10-year period. The main outcome measure was 30-day inpatient mortality. Secondary endpoints included total overnight stays, all-cause inpatient mortality, and hospitalization costs within 1 year of index admission.Inpatient mortality at 30, 100 and 365 days was estimated to be significantly greater for patients with MRSA infection. The mean additional cost of MRSA infection when controlling for additional factors was $5988 and 4 nights of additional hospital stay per patient within 1 year of index admission. Key predictors of MRSA infection were: date of index admission; higher comorbidity score; greater socio-economic disadvantage; admission to hospital other than via the emergency department; older age; and prior admission to hospital within 28 days of index admission.MRSA infection is associated with increased inpatient mortality, costs and hospital length of stay compared with MSSA infection. Efforts are required to alleviate the additional burden of MRSA infection on patients and healthcare systems.

Background The aim of this study was to identify similarities and differences in the unmet supportive care needs (USCN) of families of children with major chronic health conditions (CHCs) using a universal need assessment tool. Methods A cross-sectional online survey involving parents of children with congenital heart disease (CHD), type 1 diabetes mellitus (T1D), cancer, and asthma diagnosed within the last 5 years recruited via social media and support organizations. Thirty-four items assessing the USCN across six domains (care needs, physical and social needs, informational needs, support needs, financial needs, child-related emotional needs) were responded to on a 4-point Likert scale [no need (1) to high need (4)]. Descriptive statistics identified the level of need, and linear regressions identified factors associated with higher need domain scores. Due to small numbers, the asthma group was excluded from comparisons across CHCs. Results One hundred and ninety-four parents completed the survey (CHD: n = 97, T1D: n = 50, cancer: n = 39, and asthma: n = 8). Parents of children with cancer were most likely to report at least one USCN (92%), followed by parents of children with T1D (62%). The five most commonly reported USCN across CHCs were drawn from four domains: child-related emotional, support, care, and financial. Three need items were included in the top five needs for all conditions. A higher USCN was associated with a greater frequency of hospital visits and the absence of parental support. Conclusions Using a universal need assessment tool, this is one of the first studies to characterize USCN in families of children diagnosed with common CHCs. While proportions endorsing different needs varied across conditions, the most endorsed needs were similar across the illness groups. This suggests that support programs or services could be shared across different CHCs.

Antibacterial resistance (AR) is responsible for steadily rising numbers of untreatable bacterial infections, most prevalently found in the older adult (OA) population due to age-related physical and cognitive deterioration, more frequent and long-lasting hospital visits, and reduced immunity. There are currently no established measures of antibiotic use behaviours for older adults, and theory-informed approaches to identifying the drivers of antibiotic use in older adults are lacking in the literature. The objective of this study was to identify predictors of antibiotic use and misuse in older adults using the Antibiotic Use Questionnaire (AUQ), a measure informed by the factors of the Theory of Planned Behaviour (TPB): attitudes and beliefs, social norms, perceived behavioural control, behaviour, and a covariate—knowledge. A measure of social desirability was included, and participants scoring highly were excluded to control for social desirability bias. Confirmatory Factor Analyses and regression analyses were conducted to test the hypotheses in a cross-sectional, anonymous survey. A total of 211 participants completed the survey, 47 of which were excluded due to incompletion and high social desirability scores (≥5). Results of the factor analysis confirmed that some (but not all) factors from previous research in the general population were confirmed in the OA sample. No factors were found to be significant predictors of antibiotic use behaviour. Several suggestions for the variance in results from that of the first study are suggested, including challenges with meeting requirement for statistical power. The paper concludes that further research is required to determine the validity of the AUQ in an older adult population.

Many volcanoes exhibit evidence of long-term deformation driven by gravity. This deformation influences the development of magmatic plumbing systems and volcanic vent locations, and it manifests as earthquakes and ground surface motions. Two end-member deformation styles are volcano sagging (flexure) and volcano spreading. Previous modeling studies indicated that the mechanical and geometric properties of basement rocks below the volcano can control whether a volcano spreads or sags, but these works differed on exactly how. Furthermore, evidence in nature that a volcano may progress from sagging to spreading as it grows has not been tested experimentally. Using Digital Image Correlation (DIC) and a revised scaling approach, we here revisit the classic experiments in which a sand–plaster cone is emplaced upon a basement comprising an upper brittle layer and a lower ductile layer. In a first experiment series, we emplaced the cone instantaneously. By normalizing both brittle and ductile layer thicknesses to cone height, we provide new insight into the dimensionless geometric controls on spreading and sagging. In a novel second experiment series, we emplaced the cone incrementally. We show that as a growing cone migrates through the dimensionless geometric parameter space, its deformation style changes successively in time from sagging to spreading. DIC shows that the horizontal velocity of the cone flank increases linearly or non-linearly during cone construction, but it decreases exponentially after construction ceases. Despite their geometric simplification and the omission of several sedimentological, magmatic, and regional-tectonic processes, our models' results are compatible with a range of observations of volcanoes on Earth and Mars. In particular, they help to explain: (i) why lithosphere-scale loading results in sagging rather than spreading, and (ii) why ocean island volcanoes of >2-3 km in height develop stellate forms and rift zones.

Parkinson’s disease is a progressive neurodegenerative disorder characterised by motor dysfunction and cognitive disruption among other non-motor symptoms. No cure for Parkinson’s disease exists. Deep Brain Stimulation of the Subthalamic Nucleus (DBS STN) has been utilised for control of motor symptoms. However, cognitive deficits are commonly reported after implantation, and few exhaustive analyses exist to quantify and explain them. Our systematic review, meta-analyses, and metaregressions examine within-subjects change across thirteen cognitive domains, from 70 studies and 3000 participants at baseline measurements. Improvement was not observed in any domain, but substantial decline at 12 months was observed for phonemic and categorical fluency, which appeared to stabilise 24 to 36 months. Meta-regression suggests that few study characteristics are predictive of longitudinal outcomes, and we propose that further research into specific surgical or placement effects is necessary to mitigate short-term cognitive change after DBS STN in Parkinson’s disease.

Venus is the planet in the Solar System most similar to Earth in terms of size and (probably) bulk composition. Until the mid-20th century, scientists thought that Venus was a verdant world—inspiring science-fictional stories of heroes battling megafauna in sprawling jungles. At the start of the Space Age, people learned that Venus actually has a hellish surface, baked by the greenhouse effect under a thick, CO2-rich atmosphere. In popular culture, Venus was demoted from a jungly playground to (at best) a metaphor for the redemptive potential of extreme adversity. However, whether Venus was much different in the past than it is today remains unknown. In this review, we show how now-popular models for the evolution of Venus mirror how the scientific understanding of modern Venus has changed over time. Billions of years ago, Venus could have had a clement surface with water oceans. Venus perhaps then underwent at least one dramatic transition in atmospheric, surface, and interior conditions before present day. This review kicks off a topical collection about all aspects of Venus’s evolution and how understanding Venus can teach us about other planets, including exoplanets. Here we provide the general background and motivation required to delve into the other manuscripts in this collection. Finally, we discuss how our ignorance about the evolution of Venus motivated the prioritization of new spacecraft missions that will rediscover Earth’s nearest planetary neighbor—beginning a new age of Venus exploration., Space Science Reviews, 219 (1), ISSN:1572-9672, ISSN:0038-6308

Background Theoretically, behavioural activation may have a valuable role to play in the treatment of depression among young people with emerging/early psychosis, however we lack trial evidence concerning its acceptability and feasibility. This study will establish the feasibility of clinician-delivered behavioural activation as an adjunct to standard care for this population. We aim to train and support clinicians in delivering behavioural activation to improve depressive symptoms in young people with early/emerging psychosis. Our objectives are to: Establish the number of young people with early/emerging psychosis with clinically meaningful depression symptoms. Establish the proportion of clinicians that complete the behavioural activation training and are deemed to be competent. Determine the proportion of eligible participants approached who agree to consent to the research. Determine the proportion of participants that complete baseline measures, complete behavioural activation treatment (attending for at least fifteen minutes in a minimum of eight sessions), and complete follow-up measures (immediately post-intervention and at 3 months follow-up). Establish clinicians’ fidelity to treatment (by recording randomly selected treatment sessions and completing a fidelity checklist). Calculate preliminary efficacy of behavioural activation against primary and secondary outcomes. Explore participants’ experiences of facilitating behavioural activation (clinicians) and receiving behavioural activation (young people with emerging/early psychosis). Method This is a pilot controlled clinical trial with a two-arm parallel-group study. Approximately 60 young people with emerging/early psychosis will be randomly allocated to either behavioural activation treatment plus standard care or standard care alone. The primary outcome: depressive symptoms; and secondary outcomes: negative symptoms, overall psychiatric symptoms, medication side effects and functioning, will be assessed at baseline, post-intervention and at 3-months follow-up. The protocol is registered with the Australian New Zealand Clinical Trials Registry (reference number: ACTRN12622000756729). Discussion The findings will inform the design of a full-scale randomised controlled trial.

The Jovian moon Io features hundreds of paterae, broad depressions often filled with lava. The largest such example, Loki Patera, features a large, polygonal, and fractured island in its center. This island may reflect the fragmentation of the upper Ionian lithosphere by a shallow magma body, facilitated by a great number of shallow extensional structures. We propose a model for the Ionian lithosphere in which the upper portion is heavily deformed by joints, normal faults, and graben resulting from combined tidal, subsidence, and thermal stresses, and a lower portion rife with major thrust faults formed by horizontal compression of deeper crustal levels from the continued burial of surface units. Some of those thrusts may be reactivated normal faults. An extensionally fractured upper lithosphere accounts for the Loki Patera island, for observations of more than 175 paterae with straight edges, for the fact that almost 95% of Io’s surface is covered with volcanic flow and plains units, and for widespread instances of mass wasting within Io’s gigantic mountain blocks. Additional, high-resolution image and topographic data are required to test this hypothesized model for the moon’s lithosphere.

Objective: The objective of this study was to characterise the prevalence and/or severity of psychological distress (namely, depression and anxiety symptoms) in siblings of people with mental illness (MI) and to examine correlates of distress in siblings of people with MI. Method: Studies comparing distress in individuals with and without a sibling with MI were eligible. Studies reporting on correlates of distress in siblings were also eligible. A search of MEDLINE Complete, PsycINFO and Embase was conducted up until 17 March 2022. Results: Fifteen studies comprising 2304 siblings and 2263 comparison individuals were included. Meta-analyses indicated individuals with a sibling with MI experience significantly greater depressive symptoms (Hedges’s g = 0.53, 95% CI = [0.32, 0.73], siblings n = 1962, comparison individuals n = 2248) and anxiety symptoms (Hedges’s g = 0.40, 95% CI = [0.19, 0.61], siblings n = 653, comparison individuals n = 533) than those without. The sibling relationship, siblings’ locus of control, interpersonal functioning and their appraisal of the impacts of MI were identified as important and potentially modifiable correlates. Conclusion: Individuals with a sibling with MI experience greater depressive and anxiety symptoms than those without and would likely benefit from support. Future studies are required to elucidate the mechanisms underlying distress in siblings.

We use optimal estimation (OE) to quantify methane fluxes based on total column CH4 data from the Greenhouse Gases Observing Satellite (GOSAT) and the GEOS-Chem global chemistry transport model. We then project these fluxes to emissions by sector at 1∘ resolution and then to each country using a new Bayesian algorithm that accounts for prior and posterior uncertainties in the methane emissions. These estimates are intended as a pilot dataset for the global stock take in support of the Paris Agreement. However, differences between the emissions reported here and widely used bottom-up inventories should be used as a starting point for further research because of potential systematic errors of these satellite-based emissions estimates. We find that agricultural and waste emissions are ∼ 263 ± 24 Tg CH4 yr−1, anthropogenic fossil emissions are 82 ± 12 Tg CH4 yr−1, and natural wetland/aquatic emissions are 180 ± 10 Tg CH4 yr−1. These estimates are consistent with previous inversions based on GOSAT data and the GEOS-Chem model. In addition, anthropogenic fossil estimates are consistent with those reported to the United Nations Framework Convention on Climate Change (80.4 Tg CH4 yr−1 for 2019). Alternative priors can be easily tested with our new Bayesian approach (also known as prior swapping) to determine their impact on posterior emissions estimates. We use this approach by swapping to priors that include much larger aquatic emissions and fossil emissions (based on isotopic evidence) and find little impact on our posterior fluxes. This indicates that these alternative inventories are inconsistent with our remote sensing estimates and also that the posteriors reported here are due to the observing and flux inversion system and not uncertainties in the prior inventories. We find that total emissions for approximately 57 countries can be resolved with this observing system based on the degrees-of-freedom for signal metric (DOFS > 1.0) that can be calculated with our Bayesian flux estimation approach. Below a DOFS of 0.5, estimates for country total emissions are more weighted to our choice of prior inventories. The top five emitting countries (Brazil, China, India, Russia, USA) emit about half of the global anthropogenic budget, similar to our choice of prior emissions but with the posterior emissions shifted towards the agricultural sector and less towards fossil emissions, consistent with our global posterior results. Our results suggest remote-sensing-based estimates of methane emissions can be substantially different (although within uncertainty) than bottom-up inventories, isotopic evidence, or estimates based on sparse in situ data, indicating a need for further studies reconciling these different approaches for quantifying the methane budget. Higher-resolution fluxes calculated from upcoming satellite or aircraft data such as the Tropospheric Monitoring Instrument (TROPOMI) and those in formulation such as the Copernicus CO2M, MethaneSat, or Carbon Mapper can be incorporated into our Bayesian estimation framework for the purpose of reducing uncertainty and improving the spatial resolution and sectoral attribution of subsequent methane emissions estimates.

An often-overlooked aspect of human missions to Mars is that the optimal path to the Red Planet could include a flyby of Venus. As part of so-called opposition missions, a crewed spacecraft would, after departing Earth, approach Venus en route to Mars. Such Venus flybys would offer unique opportunities to practice deep-space human operations during phases of flight for which a direct return to Earth would be a viable abort option. Indeed, crewed flyby missions to Venus provide a basis for longer-duration human spaceflight activities before committing to longer-duration and lower-launch-cadence missions solely to Mars. During Venus flybys, astronauts bound for Mars could carry out opportunistic “human-in-the-loop” scientific activities, such as controlling an aerial platform or directing in situ sampling by a landed spacecraft for much lower cost than a dedicated crewed mission to Venus. An independent crewed Venus flyby could also serve as a useful systems demonstration mission prior to a first human mission to Mars. With a renewed focus on landing humans on Mars in the 2030s and the formidable challenges still ahead for safe and successful long-duration human spaceflight, the time to consider incorporating Venus on the path to Mars is now.

This meta-analysis examines mood changes after bilateral subthalamic deep brain stimulation (STN-DBS) in patients with Parkinson's disease (PD). Deep brain stimulation improves motor outcomes in Parkinson's disease but there appears to be conflicting reports as to subsequent mood outcomes. Pubmed, PsychINFO and SCOPUS were searched for studies assessing mood outcomes in PD patients who had undergone STN-DBS published between January 2003 and the end of January 2019. Random effects meta-analyses were conducted for all outcome groups with at least two studies homogenous in design and measure. Forty-eight studies, providing data on negative moods (such as depression, anxiety, apathy, and anger) and positive moods (pleasure and euphoria) were assessed. Results of the meta-analysis suggest that post-DBS, depression and anxiety symptoms improve and there is a reduction in negative affect, an increase in apathy, and in energy level. Although there have been reported cases of mania post-DBS surgery, the meta-analysis suggested no significant changes in symptoms of mania in the broader DBS population. Considerable heterogeneity was found and partially addressed through meta-regression and qualitative assessment of the included STN-DBS controlled studies. The major strengths of this meta-analysis, include attention to outcome validity, heterogeneity, independence of samples, and clinical utility, with the potential to improve post-operative safety through comprehensive consideration of mood and psychological adjustment. It appears that STN-DBS is a relatively safe and, in the case of mood symptomatology, an advantageous treatment of Parkinson's disease.

Increasing screen time in childhood has raised concerns about potential effects on academic achievement, with speculation that this is due in part to an overall decrease in sleep. However, research...

Background: Drought is a slow-onset natural hazard with significant socioeconomic, environmental and psychological impacts. The extant literature has predominately focused on the physical and economic dimensions of resilience, which mainly address the socioeconomic and environmental consequences of drought. However, the mental health effects of chronic environmental adversity, such as prolonged drought, remain an under-researched area, and frameworks that build and strengthen the psychological aspect of the social resilience of communities are lacking. Methods: This feasibility study will employ a mixed-method design sub-divided into three phases. Phase 1 will utilise social network analysis (SNA) to identify leadership patterns and their intersections across communities. While phase 2 will use semi-structured interviews to ascertain the perceived roles of identified leaders in preparing for and recovering from drought impacts, the third phase will adopt the Delphi method to unpack existing perceptions of control, coherence and connectedness.

This study evaluated the effects of an early education inclusion program for children with autism: ‘Understanding our Peers; the Early Years’. A series of children’s books were created outlining th...