Addressing the Population Burden of Child and Adolescent Mental Health Problems: A Primary Care Model

A model for primary care child and adolescent mental health (CAMH) services is presented, the overall goal of which is to reduce population burden of CAMH problems. The theoretical orientation of the model is based on ecological systems theories. Features of the model include: local population outcome measures; small area service focus; primary-care-based CAMH specialists; a locally comprehensive service framework based in primary care (schools and general practices); and an explicit process of community engagement. The model is illustrated by reference to a primary care CAMH service (currently the subject of a controlled trial) in Flintshire, North Wales.     

Negative affective stress reactivity: The dampening effect of snacking

The present study sets out to further elucidate the complex relationship between daily hassles, snacking, and negative affect (NA). The aim of the present study was to examine whether or not moment‐to‐moment energy intake from snacks moderates the association between momentary stress and NA. And, if so, can this moderating effect be replicated by using the amount of macronutrient intake (i.e., carbohydrates, fat, and protein) as moderator on the association between momentary stress and NA? Adults (N = 269), aged 20–50 years, participated in this study. Stress, NA, and snack intake were assessed 10 times a day for 7 consecutive days in daily life with an experience sampling smartphone application. Multilevel regression analyses were performed to assess the hypothesized associations. Our study revealed a dampening effect of snacking on negative affective stress reactivity. However, this dampening effect could not be replicated by the amount of macronutrient intake from snacks. On the contrary, the amount of carbohydrates has an enhancing effect on negative affective stress reactivity. In the end, our study suggests that the critical question is which mechanisms are decisive in the dampening role of snacking on stress reactivity. A multidisciplinary approach may provide a full perspective.     

生态扶贫视域下的中药材生态种植论析

通过对生态扶贫视域下中药材生态种植现状及发展要点进行概述,梳理生态扶贫、生态种植、中药材生态种植现状和面临的问题,着重分析中药材生态种植,探究其与生态扶贫的关联性;通过走访调研,分析中药材生态种植的经济潜力和助力脱贫发挥的作用,为依托中药材种植产业推进生态扶贫、构建优质中药材产业的发展布局、促进生态扶贫效益发展提供参考。     

半夏全球生态适宜性分析与品质生态学研究

目的 通过分析全球范围内半夏生态适宜产区,对半夏合理生产布局开展科学规划。方法 采用药用植物全球产地生态适宜性区划信息系统（GMPGIS）,以半夏道地产区、野生分布区的标本采样点气候因子值和土壤类型为依据,通过生态相似性原理,分析得出半夏全球内最大生态相似度区域。结果 半夏为广布种,在全球范围内适宜生长的面积占全球陆地面积的13.84%,适宜生长地区主要包含北美洲中部、亚洲东部及欧洲中南部。生态适宜区的国家主要包括美国、中国、加拿大、巴西等;中国适宜半夏生长的省份包括云南、四川、广西、陕西、湖南、湖北、河北、贵州等。研究结果基本包含了目前半夏栽培产区及道地产地。结论 研究结果可为半夏全球范围种质资源保护、引种栽培及高品质半夏药材生产提供参考。     

黄芩-果树间作的生态种植技术探究

目的:探究不同种植模式下黄芩产量、质量及综合效益的差异,分析黄芩-果树间作的种植技术原理,为黄芩的生态种植推广应用提供理论依据。方法:通过高效液相色谱法测定黄芩药材中黄芩苷含量,采用SPSS24.0统计软件对黄芩-果树间作移栽、单作移栽和单作直播3种种植模式下黄芩种子的千粒质量、发芽率、发芽势及3种种植模式下黄芩药材的产量、黄芩苷含量、白粉病病情指数进行统计分析。结果:与单作直播种植模式相比,黄芩-果树间作种植模式提高了黄芩种子和药材的产量,降低了黄芩白粉病病情指数,经济产值是黄芩单作移栽种植模式的2.96倍,是单作苹果种植模式的1.32倍。结论:在黄芩适宜种植区内合理利用果树下的土地资源进行黄芩-果树间作种植,不仅能减少成本投入、增加种植户的经济效益,还可以减少农药施用、提高黄芩药材的安全品质、保护和改善生态环境、实现果树与黄芩共生互利,具有较高的生态价值与社会价值。     

How to improve CHMs quality: enlighten from CHMs ecological cultivation

Chinese herbal medicines (CHMs) are one of the important bioresources of medicine, which works by unlocking nature''s ability to prevent diseases and recover from illnesses. Recently, it has ascended to the world stage and become a global icon. Nowadays, a considerable of researches have focused on the quality evaluation of CHMs. However, it is difficult to meet the reasonable needs of human beings for safe drug use to evaluate the quality of a huge number of inferior goods for the CHMs contaminated by pesticides and heavy metals. Hence to explore an eligible medicinal plant cultivation pattern, which can provide high quality CHMs sustainably, is most promising. This review analyzed the situation and characteristics of medicinal plant resources in different periods, including wild-harvested resources and domestic cultivation during different stages, putting forward that ecological cultivation must be the way to develop medicinal plant cultivation and to obtain high quality CHMs.     

Virtual reality measures in neuropsychological assessment: a meta-analytic review

Objective: Virtual reality-based assessment is a new paradigm for neuropsychological evaluation, that might provide an ecological assessment, compared to paper-and-pencil or computerized neuropsychological assessment. Previous research has focused on the use of virtual reality in neuropsychological assessment, but no meta-analysis focused on the sensitivity of virtual reality-based measures of cognitive processes in measuring cognitive processes in various populations. Method: We found eighteen studies that compared the cognitive performance between clinical and healthy controls on virtual reality measures. Results: Based on a random effects model, the results indicated a large effect size in favor of healthy controls (g = .95). For executive functions, memory and visuospatial analysis, subgroup analysis revealed moderate to large effect sizes, with superior performance in the case of healthy controls. Participants’ mean age, type of clinical condition, type of exploration within virtual reality environments, and the presence of distractors were significant moderators. Conclusions: Our findings support the sensitivity of virtual reality-based measures in detecting cognitive impairment. They highlight the possibility of using virtual reality measures for neuropsychological assessment in research applications, as well as in clinical practice.     

Sensitivity analyses for average treatment effects when outcome is censored by death in instrumental variable models

Two problems that arise in making causal inferences for nonmortality outcomes such as bronchopulmonary dysplasia (BPD) are unmeasured confounding and censoring by death, ie, the outcome is observed only when subjects survive. In randomized experiments with noncompliance and no censoring by death, instrumental variable (IV) methods can be used to control for the unmeasured confounding. But, when there is censoring by death, the average causal treatment effect cannot be identified under usual assumptions but can be studied for a specific subpopulation by using sensitivity analysis with additional assumptions. However, evaluating the local average treatment effect (LATE) in observational studies with censoring by death problems while controlling for unmeasured confounding is not well studied. We develop a novel sensitivity analysis method based on IV models for studying the LATE. Specifically, we present the identification results under an additional assumption and propose a three-step procedure for the LATE estimation. Also, we propose an improved two-step procedure by simultaneously estimating the instrument propensity score (ie, the probability of instrument given covariates) and the parameters induced by the assumption. We show with simulation studies that the two-step procedure can be more robust and efficient than the three-step procedure. Finally, we apply our sensitivity analysis methods to a study on the effect of delivery at high-level neonatal intensive care units on the risk of BPD.     

Towards an ecological understanding of readiness to engage with interventions for children exposed to domestic violence and abuse: Systematic review and qualitative synthesis of perspectives of children,parents and practitioners

Children who grow up in homes affected by domestic violence and abuse (DVA) are at risk of poor outcomes across the lifespan, yet there is limited evidence on the acceptability and effectiveness of interventions for them. A recent review of child‐focused interventions highlighted a gap in understanding the factors influencing the willingness of parents and children to engage with these programmes. We conducted a systematic review of qualitative evidence on the experiences of receiving and delivering interventions with the aim of identifying factors at different levels of the social–ecological context that may influence parent and child readiness to take up interventions. We searched literature till April 2016 and found 12 reports of eight programmes. Two authors independently screened papers for inclusion, extracted data and identified the first‐ and second‐order constructs. The third‐order constructs were derived and fitted to the ecological framework to inform a picture of readiness to engage with interventions. Three key findings emerged from this review: (a) parent and child readiness is influenced by a complex interplay of individual, relationship and organisational factors, highlighting that individual readiness to take up child‐focussed interventions must be viewed in an ecological context; (b) the specific process through which women become ready to engage in or facilitate child‐focussed interventions may differ from that related to uptake of safety‐promoting behaviours and requires parents to be aware of the impact of DVA on children and to focus on children's needs; (c) there are distinct but interlinked processes through which parents and children reach a point of readiness to engage in an interventions aimed at improving child outcomes. We discuss the implications of these findings for both practice and research.