Now showing items 1-15 of 15

• #### Development and validation of a non-remission risk prediction model in first episode psychosis: an analysis of two longitudinal studies

Abstract Psychosis is a major mental illness with first onset in young adults. The prognosis is poor in around half of the people affected, and difficult to predict. The few tools available to predict prognosis have major weaknesses which limit their use in clinical practice. We aimed to develop and validate a risk prediction model of symptom non-remission in first-episode psychosis. Our development cohort consisted of 1027 patients with first-episode psychosis recruited between 2005 to 2010 from 14 early intervention services across the National Health Service in England. Our validation cohort consisted of 399 patients with first-episode psychosis recruited between 2006 to 2009 from a further 11 English early intervention services. The one-year non-remission rate was 52% and 54% in the development and validation cohorts, respectively. Multivariable logistic regression was used to develop a risk prediction model for non-remission, which was externally validated. The prediction model showed good discrimination (C-statistic of 0.73 (0.71, 0.75) and adequate calibration with intercept alpha of 0.12 (0.02, 0.22) and slope beta of 0.98 (0.85, 1.11). Our model improved the net-benefit by 15% at a risk threshold of 50% compared to the strategy of treating all, equivalent to 15 more detected non-remitted first-episode psychosis individuals per 100 without incorrectly classifying remitted cases. Once prospectively validated, our first episode psychosis prediction model could help identify patients at increased risk of non-remission at initial clinical contact.
• #### Development and Validation of a Nonremission Risk Prediction Model in First-Episode Psychosis: An Analysis of 2 Longitudinal Studies

Abstract Psychosis is a major mental illness with first onset in young adults. The prognosis is poor in around half of the people affected, and difficult to predict. The few tools available to predict prognosis have major weaknesses which limit their use in clinical practice. We aimed to develop and validate a risk prediction model of symptom nonremission in first-episode psychosis. Our development cohort consisted of 1027 patients with first-episode psychosis recruited between 2005 and 2010 from 14 early intervention services across the National Health Service in England. Our validation cohort consisted of 399 patients with first-episode psychosis recruited between 2006 and 2009 from a further 11 English early intervention services. The one-year nonremission rate was 52% and 54% in the development and validation cohorts, respectively. Multivariable logistic regression was used to develop a risk prediction model for nonremission, which was externally validated. The prediction model showed good discrimination C-statistic of 0.73 (0.71, 0.75) and adequate calibration with intercept alpha of 0.12 (0.02, 0.22) and slope beta of 0.98 (0.85, 1.11). Our model improved the net-benefit by 15% at a risk threshold of 50% compared to the strategy of treating all, equivalent to 15 more detected nonremitted first-episode psychosis individuals per 100 without incorrectly classifying remitted cases. Once prospectively validated, our first episode psychosis prediction model could help identify patients at increased risk of nonremission at initial clinical contact.

• #### Galerkin finite element approximation of a stochastic semilinear fractional subdiffusion with fractionally integrated additive noise

Abstract A Galerkin finite element method is applied to approximate the solution of a semilinear stochastic space and time fractional subdiffusion problem with the Caputo fractional derivative of the order $\alpha \in (0, 1)$, driven by fractionally integrated additive noise. After discussing the existence, uniqueness and regularity results, we approximate the noise with the piecewise constant function in time, in order to obtain a regularized stochastic fractional subdiffusion problem. The regularized problem is then approximated by using the finite element method in spatial direction. The mean squared errors are proved based on the sharp estimates of the various Mittag–Leffler functions involved in the integrals. Numerical experiments are conducted to show that the numerical results are consistent with the theoretical findings.
• #### Introducing Social Workers: Their Roles and Training

Abstract During the late Victorian and early Edwardian period references to ‘social work’ in the UK emerged in the context of the movement for social reform. Using a wide variety of contemporary literature, archival sources and Internet searches this article finds that, alongside charitable and philanthropic work, the term ‘social work’ referred to a particularly wide range of social, health, educational, industrial welfare and recreation activity. Few attempts were made to attribute an explicit meaning to the term and it was not used as frequently as is sometimes implied by commentaries about the period. However, voluntary and paid workers were increasingly referred to collectively as ‘social workers’ and became the subject of increasing discussion about their roles and need for training. This article traces the developments in references to social work and social workers in the literature and highlights the early debate that took place in the UK and USA about the relative importance of practical work and study of the social sciences, introducing the tension which characterised social workers’ subsequent difficulties in establishing a professional identity.
• #### Late diagnosis of isolated central diabetes insipidus secondary to congenital toxoplasmosis—case report

ABSTRACT Congenital toxoplasmosis is an uncommon infection. Hypothalamic/pituitary involvement leading to isolated central diabetes insipidus is extremely rare. Making a correct diagnosis of this condition, albeit challenging, is crucial for adequate management. We present a 54-year-old female who developed central diabetes insipidus as a complication of congenital toxoplasmosis. She had polydipsia and hypernatraemia on presentation and responded to intranasal desmopressin with normalization of above-mentioned findings. Magnetic resonance imaging and cranial X-ray’s showed pronounced intracranial calcifications in both choroid plexuses. Thyroid function tests, serum cortisol level and anterior pituitary function were all normal. To the best of our knowledge, this is the first reported case of isolated diabetes insipidus due to congenital toxoplasmosis in literature diagnosed late in adulthood and gives an insight into the challenges of diagnosing central diabetes insipidus and the hypothalamic/pituitary involvement in cases of congenital toxoplasmosis.