Social Functioning Research Articles

What’s the Point of Authors?

In this paper, I want to start to untangle some of the philosophical issues associated with our practices of ascribing authorship for collaborative work, with an eye to formulating better guidelines for authorship. I will focus on the following questions: 1. What epistemic, social, and ethical functions are played by our practices of ascribing authorship for academic papers? 2. What ways of ascribing authorship would best address these functions? Can any one way of ascribing authorship address all of the functions? I hope to make three contributions. First, I hope to build on established debates about authorship to offer a general framework for assessing practices of assigning authorship. Secondly, to argue that the different functions of authorship are incoherent, making different predictions about who should be an author. Thirdly, I will argue that this incoherence points in the direction of replacing the role of an author with a number of different roles which address the different functions. In the final section I will set out a proposal that does just this, which I will call the no author account of authorship.

A living lab to develop smart home services for the residential welfare of older adults

Owing to the decline in the physical and social functions of older adults, the residential environment substantially impacts the psychological and emotional stability and life satisfaction for older adults. Recently, there has been a growing interest in providing residential welfare services related to the health and independent living of the older adults. The primary objective of this research was to identify the needs and perceptions of older adults regarding smart home services and associated sensors and evaluate the indoor environment conditions of older adults through a living lab. Survey results indicate that older adults felt the burden of electricity bills in summer and winter and had relatively high safety-related smart home service needs. Focus group interviews with the participants in the living lab confirmed that older adults positively perceived the benefits and privacy of the living-lab sensors. In addition, the analysis of indoor environment data over one year from a case study household showed that approximately 66.4 % during the winter season and 13.1 % during the summer season have fallen within the neutral thermal comfort range according to the proposed approach (i.e., predicted mean vote (PMV) calculated using heart rate). This study adopted the proposed PMV method (hereafter PMV-P) that takes into account personal factors (e.g., metabolic rate of older adults that can be calculated using heart rate) and environmental factors (e.g., temperature, humidity) by using the real-time data collected from IoT (Internet of Things)-based sensors. Furthermore, this study proposed a new home energy management system (EMS) algorithm on the basis of model predictive control for reducing heating energy consumption while satisfying the thermal comfort. The new EMS was demonstrated to achieve 5–12 % heating energy savings depending on the thermal comfort preferences of occupants. Overall, the results of multidisciplinary research not only provided the preliminary evidence regarding the needs and perceptions of older adults toward IoT-based sensors but also showcased the development of IoT-based smart home service system through the living lab.

Japanese value set for the EORTC QLU-C10D: A multi-attribute utility instrument based on the EORTC QLQ-C30 cancer-specific quality-of-life questionnaire

PurposeThis study aimed to develop a Japanese value set for the EORTC QLU-C10D, a multi-attribute utility measure derived from the cancer-specific health-related quality-of-life (HRQL) questionnaire, the EORTC QLQ-C30. The QLU-C10D contains ten HRQL dimensions: physical, role, social and emotional functioning, pain, fatigue, sleep, appetite, nausea, and bowel problems.MethodsQuota sampling of a Japanese online panel was used to achieve representativeness of the Japanese general population by sex and age (≥ 18 years). The valuation method was an online discrete choice experiment. Each participant considered 16 choice pairs, randomly assigned from 960 choice pairs. Each pair included two QLU-C10D health states and life expectancy. Data were analyzed using conditional logistic regression, parameterized to fit the quality-adjusted life-year framework. Preference weights were calculated as the ratio of each dimension-level coefficient to the coefficient for life expectancy.ResultsA total of 2809 eligible panel members consented, 2662/2809 (95%) completed at least one choice pair, and 2435/2662 (91%) completed all choice pairs. Within dimensions, preference weights were generally monotonic. Physical functioning, role functioning, and pain were associated with the largest utility weights. Intermediate utility weights were associated with social functioning and nausea; the remaining symptoms and emotional functioning were associated with smaller utility decrements. The value of the worst health state was − 0.221, lower than that seen in most other existing QLU-C10D country-specific value sets.ConclusionsThe Japan-specific QLU-C10D value set is suitable for evaluating the cost and utility of oncology treatments for Japanese health technology assessment and decision-making.

A pre-post study design: evaluating the effectiveness of a new community-based integrated service model on patient outcomes

This study aimed to evaluate a new service model, Specialists Together In the Community (STIC), in terms of patient outcomes. This model integrates Flexible Assertive Community Treatment (FACT)-principles with expertise of specialized teams that offer diagnosis-related outpatient treatment. In a pre-post design, symptoms and quality of life of 930 former FACT-patients were measured repeatedly pre- and post-STIC. Regarding patients in former specialized teams, pre- and post-treatment social functioning and symptoms were measured for the pre- (n = 944) and post-STIC (n = 544) groups. Against expectation, symptoms of former FACT-patients remained stable post-STIC compared to a slight decrease pre-STIC. According to expectation, pre- and post-STIC groups had an equal symptom reduction. Unexpectedly, the post-STIC group did not improve more on social functioning than the pre-STIC group. Explorative analysis showed less treatment contacts in the post-STIC group. The highly similar patient outcomes post-STIC could be improved by monitoring process outcomes and prolonging study duration.

Taboo language across the globe: A multi-lab study

The use of taboo words represents one of the most common and arguably universal linguistic behaviors, fulfilling a wide range of psychological and social functions. However, in the scientific literature, taboo language is poorly characterized, and how it is realized in different languages and populations remains largely unexplored. Here we provide a database of taboo words, collected from different linguistic communities (Study 1, N = 1046), along with their speaker-centered semantic characterization (Study 2, N = 455 for each of six rating dimensions), covering 13 languages and 17 countries from all five permanently inhabited continents. Our results show that, in all languages, taboo words are mainly characterized by extremely low valence and high arousal, and very low written frequency. However, a significant amount of cross-country variability in words’ tabooness and offensiveness proves the importance of community-specific sociocultural knowledge in the study of taboo language.

Comprehensive dry eye therapy: overcoming ocular surface barrier and combating inflammation, oxidation, and mitochondrial damage

BackgroundDry Eye Disease (DED) is a prevalent multifactorial ocular disease characterized by a vicious cycle of inflammation, oxidative stress, and mitochondrial dysfunction on the ocular surface, all of which lead to DED deterioration and impair the patients’ quality of life and social functioning. Currently, anti-inflammatory drugs have shown promising efficacy in treating DED; however, such drugs are associated with side effects. The bioavailability of ocular drugs is less than 5% owing to factors such as rapid tear turnover and the presence of the corneal barrier. This calls for investigations to overcome these challenges associated with ocular drug administration.ResultsA novel hierarchical action liposome nanosystem (PHP-DPS@INS) was developed in this study. In terms of delivery, PHP-DPS@INS nanoparticles (NPs) overcame the ocular surface transport barrier by adopting the strategy of “ocular surface electrostatic adhesion-lysosomal site-directed escape”. In terms of therapy, PHP-DPS@INS achieved mitochondrial targeting and antioxidant effects through SS-31 peptide, and exerted an anti-inflammatory effect by loading insulin to reduce mitochondrial inflammatory metabolites. Ultimately, the synergistic action of “anti-inflammation-antioxidation-mitochondrial function restoration” breaks the vicious cycle associated with DED. The PHP-DPS@INS demonstrated remarkable cellular uptake, lysosomal escape, and mitochondrial targeting in vitro. Targeted metabolomics analysis revealed that PHP-DPS@INS effectively normalized the elevated level of mitochondrial proinflammatory metabolite fumarate in an in vitro hypertonic model of DED, thereby reducing the levels of key inflammatory factors (IL-1β, IL-6, and TNF-α). Additionally, PHP-DPS@INS strongly inhibited reactive oxygen species (ROS) production and facilitated mitochondrial structural repair. In vivo, the PHP-DPS@INS treatment significantly enhanced the adhesion duration and corneal permeability of the ocular surface in DED mice, thereby improving insulin bioavailability. It also restored tear secretion, suppressed ocular surface damage, and reduced inflammation in DED mice. Moreover, it demonstrated favorable safety profiles both in vitro and in vivo.ConclusionIn summary, this study successfully developed a comprehensive DED management nanosystem that overcame the ocular surface transmission barrier and disrupted the vicious cycle that lead to dry eye pathogenesis. Additionally, it pioneered the regulation of mitochondrial metabolites as an anti-inflammatory treatment for ocular conditions, presenting a safe, efficient, and innovative therapeutic strategy for DED and other inflammatory diseases.

Exploring unmet needs and preferences of young adult stroke patients for post-stroke care through PROMs and gender differences

BackgroundStroke incidence among young adults of working age (under 65 years of age) has significantly increased in the past decade, with major individual, social, and economic implications. There is a paucity of research exploring the needs of this patient population. This study assessed: (1) young adult stroke patients' physical, psychological, and occupational functioning and health-related quality of life (HRQoL); and (2) post-stroke care preferences using patient-reported outcome measures (PROMs), with attention to gender differences.MethodsA cross-sectional pilot study was conducted. Sociodemographic and clinical characteristics were collected through chart review and data on occupational function, physical, psychological, and social wellbeing >90 days post-stroke through a self-reported survey. Descriptive statistics, gender-based, and regression analyses were conducted.ResultsThe sample included 85 participants. Participants reported impairments in both, occupational functioning, with 58.7% not returned to work (RTW), and HRQoL, specifically with social activities (37%), anxiety (34%), and cognitive function (34%). Women had significantly (p < 0.05) worse physical symptoms (sleep disturbance and fatigue), emotional health (depression, stigma, emotional dyscontrol) scores, and sense of self-identify post-stroke. Over 70% of participants preferred in-person post-stroke care led by health care providers and felt they would have benefited from receiving information on physical health (71.4%), emotional and psychological health (56.0%), RTW (38.1%), and self-identity (26.2%) post-stroke. Women preferred cognitive behavioral therapy (p = 0.018) and mindfulness-based stress reduction therapy (p = 0.016), while men preferred pharmacotherapy (p = 0.02) for psychological symptoms.ConclusionThis is the first study to report impaired HRQoL, psychological and occupational functioning using PROMs, with significant gender differences and preferences for post-stroke care delivery among young adult stroke patients at >90 days after stroke. The findings highlight the importance of needs, gender, and age-specific post-stroke education and interventions.

Comparing the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, personality disorder models scored from the same interview.

The alternative model of personality disorders (AMPD) traits were designed to maintain continuity with the Section II personality disorder (PD) diagnoses by retaining the same clinical information. Whether the AMPD traits achieve this is not well established. Prior work testing incremental validity of AMPD traits and Section II diagnoses is limited by the fact each model was measured by a different instrument or rater, making it unclear whether discrepancies are due to the constructs or methods. Here, we compare the incremental validity of AMPD traits versus Section II PDs assessed by the same instrument and rater. Participants (N = 311, 50% received past-year mental health treatment) completed a clinical interview, baseline self-reports, and 14-day ambulatory assessment protocol. Interviewers rated AMPD domains, facets, and Section II criteria from the same interview (Structured Interview for DSM-IV Personality). We used hierarchical regression models to evaluate the variance predicted in 17 clinically relevant cross-sectional and momentary variables by the AMPD traits and Section II PDs. Incremental R² showed that Section II PDs account for little variance in outcomes over and above the AMPD domains/facets, whereas the AMPD facets were generally more predictive of outcomes than the Section II PDs. Results add novel evidence that dimensional PD traits-not a particular assessment method-are equivalent or superior to PD categories for predicting social, emotional, and behavioral functioning. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Comparison of Lifestyles, Mental Risks, and Physical Indices among Individuals with Ultra-High Risk of Psychosis, Patients with Schizophrenia, and the General Public.

(1) Background: Early interventions may effectively reduce the risk of mental disorders in individuals with ultra-high risk. Specifying the health needs of individuals with ultra-high risk is crucial before the implementation of successful early intervention. This study aimed to explore the differences in lifestyles, mental risks, and physical indices among individuals with ultra-high risk, patients with schizophrenia, and healthy subjects. (2) Methods: A cross-section design applying seven questionnaires with physical examinations for 144 participants aged 13-45 years old was conducted in this study. The questionnaires included one about personal data, four on mental risks, and two for lifestyles. (3) Results: The individuals with ultra-high risk scored similarly in many dimensions as the patients with schizophrenia, but they displayed lower positive symptoms, lower negative symptoms, lower prodromal symptoms, higher interpersonal deficits, lower nutrition intake, and higher levels of exercise than the patients with schizophrenia. Female individuals with ultra-high risk had lower self-esteem, higher positive symptoms, lower nutrition intake, and higher exercise levels than male ones. (4) Conclusions: The study pinpointed specific health needs with interpersonal deficits, nutrition intake, and physical activity for the individuals with ultra-high risk. Future interventions targeted on improving social function, dietary pattern, and exercise will be beneficial.

Factor Structure of the Experiences in Close Relationships-Relationship Structures Scale (ECR-RS) in Siblings of Children with Chronic Disorders.

Our objective was to examine the factor structure of the Experiences in Close Relationships-Relationships Structures (ECR-RS), an attachment-theory based relationship measure, in at-risk sample comprising siblings of children with chronic disorders. Psychometric studies with general populations have demonstrated that the ECR-RS comprises two factors, representing anxiety and avoidance in close relationships. The sample comprised 103 siblings (M age = 11.5 years, SD = 2.2, range 8 to 16 years) of children with chronic disorders and their parents. The siblings completed a 9-item version of the Experiences in Close Relationships-Relationships Structures (ECR-RS) about their relations with mothers and fathers that was analyzed with confirmatory factor analysis. We examined construct validity using correlations between sibling social functioning, measured with the Strengths and Difficulties Questionnaire, and parent mental health, measured with the Hopkins Symptom Checklist-90-Revised. The ECR-RS comprised two factors, anxiety and avoidance, in line with previous studies. Both factors demonstrated significant overlap with sibling social functioning, but not with parental mental health. We conclude that the ECR-RS comprises two factors, anxiety and avoidance, that are related to siblings' social functioning. The ECR-RS can be used as a psychometrically sound measure of relationship anxiety and avoidance in families of children with chronic disorders.

OUTCOMES OF REVISION TOTAL ANKLE ARTHROPLASTY: A MINIMUM OF TWO-YEAR FOLLOW-UP

IntroductionTotal ankle replacement as a valid treatment for end stage ankle arthritis, is gaining popularity and every year there is an increasing number of procedures. With revision rates as high as 21% at 5 years and 43% at 10 years there is a need for understanding and reporting the outcome of revision ankle replacement. Our aim was to study the patient reported outcomes following revision TAR with a minimum of 2 year follow up.MethodsAll patients that underwent a revision total ankle replacement between 2012 and 2016 were included in the study. All patients received a post-operative questionnaire comprising of MOX-FQ score, EQ-5D (UK) and Foot and Ankle outcomes scores (FAOS) and patients satisfaction questionnaire with a minimum of 2 years follow up.Results33 patients had a revision total ankle replacement between 2012 and 2016. 2 patients were deceased therefore 31 patients were included in the study. 4 patients declined participation for completing questionnaires. We received 15/27 (55.5%) completed questionnaires. The mean MOX-FQ average domain score for pain was (50.6 ± 26.9), walking/standing (62.4 ± 36.5) and social function was (43.7± 31.0). The mean FAOS scores were (52.5 ± 30.6; pain), (54.5 ± 29.2; symptoms), (62.1 ± 30.5; ADL) and (35.5 ± 28.2; for quality of life). The mean overall health score today for EQ-5D was 73.9/100. 50% of patients were satisfied with the pain relief and return to sports and recreation obtained following the operation, 57% were satisfied with the improved in daily activities. 78.5% were overall satisfied with the results from surgery.ConclusionRevision total ankle replacement gives overall satisfactory results demonstrated from patients reported outcomes at a minimum of 2 years following surgery.

Research on the Application of Virtual Anchors based on Artificial Intelligence Technology in Live Streaming E-commerce

With the increasing training and labor costs of live streaming e-commerce industry anchors, as well as the continuous progress of artificial intelligence technology, virtual live streaming anchors have gradually become the new favorite of live streaming e-commerce enterprises due to their strong stability and low cost characteristics. In this context, this article takes virtual anchors in live streaming e-commerce as the research object, and uses literature research and case analysis methods to study the application of virtual anchors. This article analyzes the current application status of virtual anchors in live streaming e-commerce, and analyzes the problems that exist in the application process, such as weak social functions of virtual anchors, low number of main consumer users, low degree of differentiated competition, and facing information security governance risks. Finally, based on the current reality of virtual live streaming e-commerce, strategies and suggestions are proposed to optimize the use of live streamers and virtual streamers, select appropriate product categories for virtual streamers, strengthen the cultivation of virtual live streaming operation talents, and build a diverse collaborative governance framework to enhance the application of virtual streamers.

The Anti-Open Grazing Policy and Farmers-Herders’ Conflicts in Benue State, Nigeria

This study examines anti-open grazing policy and farmers-herders’ conflicts in Benue State, in order to ascertain the extent, the law was able to ameliorate the persisted farmers-herders’ conflicts and restores peace in the state. The study was anchored on the theory of structural functionalism as its analytical compass of study. The study adopted documentary method of data collection, content analysis for analysing data generated through secondary sources. It revealed that the prohibition of movement of livestock on foot, prohibition of firearms and the establishment of ranches by anti-open grazing policy ameliorated farmers-herders’ conflicts in Benue State. We recommended amongst other things, that Benue State Government should partner with the Federal Government, security agencies and neighbouring states in the fight against killer herdsmen by introducing more stifling policies, programme and workshops capable of stimulating peace, love, tranquillity and respect for human life in the state.

Autism in girls: ‘Camouflaging,’ social functioning, and diagnostic dilemmas

The subject of autism spectrum disorder (ASD) diagnosis in girls has become an important area of clinical and research focus. For years, the male:female ratio of ASD has been estimated as approximately 4:1, with affected girls historically presenting with a higher likelihood of significant intellectual impairments. Clinicians and researchers have increasingly questioned this ratio, with findings indicating that girls with average or higher intellectual and/or verbal functioning have a different phenotype than males affected with ASD.

Cognitive, social, and mental health functions of refugee children – screening and supportive actions at school: a study protocol

BackgroundDespite a world-leading educational system, an achievement gap in educational outcomes exists between children of refugee background and native-born peers in Finland. To offer targeted support for children at schools, we need to be able to reliably assess and understand the interplay of the aspects of children’s cognitive, social, and mental health functions that may explain the underachievement of refugee children.This study tests a novel research-based, universally applicable screening battery for evaluating cognitive, social, and mental health functioning of children at schools and planning supportive actions. It aims to answer research questions about a) the cognitive, social, and mental health functioning of refugee children compared with non-refugee immigrant and native-born children, b) the interplay of these different functions among refugee and other children, c) whether implementing a screening battery can inform schools in planning supportive actions for (refugee) children, and d) whether such supportive actions result in improvements in cognitive, social, and mental health functioning.MethodsFour hundred fifty children aged 10–12 will be recruited from primary schools, including 150 children of refugee background, 150 of non-refugee immigrant background, and 150 native-born Finnish children. A screening battery including tasks and questionnaires on different aspects of cognitive, social, and mental health functioning will be used to assess the children in their classrooms at the start and end of a school year. Supporting information will also be collected from parents and teachers. The information gathered will be collated into class-level feedback reports for teachers and, with parental permission, individualized reports for multiprofessional student welfare bodies, for informing supportive actions. Correlational and latent profile analyses, ANOVAs, and linear regression will be used to answer the research questions.DiscussionThis study will help clarify how the interplay of cognitive, social, and mental health factors may explain underachievement at school among refugee children. It will provide evidence about the extent to which a standardized screening battery could be helpful in informing and planning supportive actions for children at schools, and whether such supportive actions can lead to positive cognitive, social, or mental health outcomes.Trial registrationThe study will be preregistered on the Open Science Framework.

Prenatal & Perinatal Risk Factors of Autism Spectrum Disorder

Background: Autism spectrum disorder (ASD) is lifelong neurodevelopmental disorder characterized by impairments in social function, communication, and certain behaviors. The etiology of ASD is unclear & it is believed to be multi-factorial, among those several prenatal & perinatal factors are found to be significant. So, the necessity of this study is to detect the presence of known risk factors of ASD which in turn may help in the early diagnosis and intervention for better long-term outcomes. Objective: To find out prenatal and perinatal risk factors of ASD. Method: A case control study was conducted with 112 cases of ASD and 201 controls of 2-6 years of age. The study was carried out in Center for Neurodevelopment and Autism in Children (CNAC), in the department of Paediatrics, Bangabandhu Sheikh Mujib Medical University and Autism Welfare Foundation (AWF). ASD was diagnosed by DSM-IV TR criteria. Mothers were interviewed and data were collected by semistructured questionnaires. Results: Total 5 risk factors were identified as the risk factors of ASD. They were: advanced paternal age (OR=2.84) and maternal age (OR=1.87); male baby (OR=2.01); environmental stress during pregnancy (OR=1.61) and preterm delivery (OR=1.80). Conclusions: It is concluded that advanced paternal age, maternal age, male baby, environmental stress during pregnancy and preterm delivery are associated with increased risk of ASD. BANGLADESH J CHILD HEALTH 2022; VOL 46 (3) : 115-121

Transdiagnostic considerations are critical to understanding childhood neurodevelopmental disorders.

Growing dissatisfaction with the current categorical diagnostic systems has led to a movement toward transdiagnostic dimensional approaches to assessment of childhood mental health disorders. We argue that a transdiagnostic approach is especially important and appropriate when screening for neurodevelopmental disorders during early childhood. In the early childhood years, symptoms often appear in the form of developmental delays that could portend a variety of different disorders. Early intervention at this point is critical, even though a final endpoint disorder is not yet apparent. Intervening early has the potential to grow the area of weakness, possibly correcting or at least ameliorating these delays. Early intervention requires a multidisciplinary approach integrating efforts across settings and providers that monitor the development of young children. We argue here that young children's language ability is central to the development of social cognition, and a prerequisite for adequate social functioning. Social deficits are defining features of a subset of neurodevelopmental disorders such as autism spectrum disorder and social (pragmatic) communication disorder. Critically, impairment in social functioning is common in additional neurodevelopmental disorders such as attention-deficit/hyperactivity disorder (ADHD), learning disorders, and even motor disorders. For this reason, we argue that, at the earliest sign of a possible neurodevelopmental disorder, children should be screened for language deficits prior to initiating a focused assessment for a specific type of neurodevelopmental disorder such as ADHD. Any detected language deficits should be considered in the design and implementation of the assessment, as well as the ultimate intervention plan.

Collaborative care approaches for people with severe mental illness.

Collaborative care for severe mental illness (SMI) is a community-based intervention that promotes interdisciplinary working across primary and secondary care. Collaborative care interventions aim to improve the physical and/or mental health care of individuals with SMI. This is an update of a 2013 Cochrane review, based on new searches of the literature, which includes an additional seven studies. To assess the effectiveness of collaborative care approaches in comparison with standard care (or other non-collaborative care interventions) for people with diagnoses of SMI who are living in the community. We searched the Cochrane Schizophrenia Study-Based Register of Trials (10 February 2021). We searched the Cochrane Common Mental Disorders (CCMD) controlled trials register (all available years to 6 June 2016). Subsequent searches on Ovid MEDLINE, Embase and PsycINFO together with the Cochrane Central Register of Controlled Trials (with an overlap) were run on 17 December 2021. Randomised controlled trials (RCTs) where interventions described as 'collaborative care' were compared with 'standard care' for adults (18+ years) living in the community with a diagnosis of SMI. SMI was defined as schizophrenia, other types of schizophrenia-like psychosis or bipolar affective disorder. The primary outcomes of interest were: quality of life, mental state and psychiatric admissions at 12 months follow-up. Pairs of authors independently extracted data. We assessed the quality and certainty of the evidence using RoB 2 (for the primary outcomes) and GRADE. We compared treatment effects between collaborative care and standard care. We divided outcomes into short-term (up to six months), medium-term (seven to 12 months) and long-term (over 12 months). For dichotomous data we calculated the risk ratio (RR) and for continuous data we calculated the standardised mean difference (SMD), with 95% confidence intervals (CIs). We used random-effects meta-analyses due to substantial levels of heterogeneity across trials. We created a summary of findings table using GRADEpro. Eight RCTs (1165 participants) are included in this review. Two met the criteria for type A collaborative care (intervention comprised of the four core components). The remaining six met the criteria for type B (described as collaborative care by the trialists, but not comprised of the four core components). The composition and purpose of the interventions varied across studies. For most outcomes there was low- or very low-certainty evidence. We found three studies that assessed the quality of life of participants at 12 months. Quality of life was measured using the SF-12 and the WHOQOL-BREF and the mean endpoint mental health component scores were reported at 12 months. Very low-certainty evidence did not show a difference in quality of life (mental health domain) between collaborative care and standard care in the medium term (at 12 months) (SMD 0.03, 95% CI -0.26 to 0.32; 3 RCTs, 227 participants). Very low-certainty evidence did not show a difference in quality of life (physical health domain) between collaborative care and standard care in the medium term (at 12 months) (SMD 0.08, 95% CI -0.18 to 0.33; 3 RCTs, 237 participants). Furthermore, in the medium term (at 12 months) low-certainty evidence did not show a difference between collaborative care and standard care in mental state (binary) (RR 0.99, 95% CI 0.77 to 1.28; 1 RCT, 253 participants) or in the risk of being admitted to a psychiatric hospital at 12 months (RR 5.15, 95% CI 0.67 to 39.57; 1 RCT, 253 participants). One study indicated an improvement in disability (proxy for social functioning) at 12 months in the collaborative care arm compared to usual care (RR 1.38, 95% CI 0.97 to 1.95; 1 RCT, 253 participants); we deemed this low-certainty evidence. Personal recovery and satisfaction/experience of care outcomes were not reported in any of the included studies. The data from one study indicated that the collaborative care treatment was more expensive than standard care (mean difference (MD) international dollars (Int$) 493.00, 95% CI 345.41 to 640.59) in the short term. Another study found the collaborative care intervention to be slightly less expensive at three years. This review does not provide evidence to indicate that collaborative care is more effective than standard care in the medium term (at 12 months) in relation to our primary outcomes (quality of life, mental state and psychiatric admissions). The evidence would be improved by better reporting, higher-quality RCTs and the assessment of underlying mechanisms of collaborative care. We advise caution in utilising the information in this review to assess the effectiveness of collaborative care.

Minority language happiness: The link between social inclusion, well-being, and speaking a regional language in the northern Netherlands

Belonging to groups is often based on shared features between members and is associated with higher levels of (social) well-being. One especially strong marker of one's group membership is language. In linguistics, most research about group membership and well-being focuses on migrants and refugees. However, very little research has focused on the link between speaking a regional language and well-being. This is surprising, as regional languages index a strong shared in-group identity that could lead to exclusion of those who do not speak them. As a first empirical step, this paper reports on the association between regional language use (specifically, of Frisian and Low Saxon) and social well-being. We distributed a language background questionnaire to participants of the Lifelines cohort, a multigenerational cohort study comprising data from 167,729 participants living in the north of the Netherlands. In both language contexts (Frisian in Fryslân, and Low Saxon in Groningen and Drenthe), those using the regional language half of the time or more were found to have significantly more social contacts. They also experienced higher levels of social embeddedness than those who did not know or did not frequently use the regional language. The higher degree of social embeddedness for frequent regional language users was most strongly present in rural areas. Furthermore, we found that frequent users of Frisian living in Fryslân had higher levels of social embeddedness in rural areas than frequent users of Low Saxon living in Groningen or Drenthe. No effect was found for more overt measures of social well-being such as loneliness or life satisfaction. While our results confirm an association between regional language speaking and some indices of social functioning on a large scale, they cannot uncover a causal relationship between the two. We discuss how longitudinal studies and interviews in future studies may inform us further about the relation between regional language use and social well-being.

The conceptual injustice of the brain death standard.

Family disputes over the diagnosis of brain death have caused much controversy in the bioethics literature over the conceptual validity of the brain death standard. Given the tenuous status of brain death as death, it is pragmatically fruitful to reframe intractable debates about the metaphysical nature of brain death as metalinguistic disputes about its conceptual deployment. This new framework leaves the metaphysical debate open and brings into focus the social functions that are served by deploying the concept of brain death. In doing so, it highlights the epistemic injustice of medicolegal authorities that force people to uniformly accept brain death as a diagnosis of death based on normative considerations of institutional interests, such as saving hospital resources and organ supplies, rather than empirical evidence of brain death as death, which is insufficient at best and nonexistent at worst. In light of this injustice, I propose the rejection of the uniform standard of brain death in favor of a choice-based system that respects families' individualized views of death.