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Clinical interviewing is a flexible method for gathering assessment information and initiating psychotherapy. Clinical interviews can be used to establish therapeutic relationships, provide role inductions for psychotherapy, gather assessment information, develop case formulations/treatment plans, and for implementing therapeutic interventions. When used for assessment or intake purposes, clinical interviews focus on specific content, such as psychodiagnosis, mental status, and suicide risk. Although central to psychodiagnostic assessment, interview reliability and validity can be adversely affected by noncredible client responding (e.g., the over- or underreporting of symptoms). To address noncredible client responding, clinicians need to (1) be aware of the potential for inaccurate reporting, (2) adopt a “scientific mindedness” approach, (3) manage their countertransference, (4) use specific questioning or interpersonal strategies, and (5) triangulate data by using information from multiple sources. Undoubtedly, technology and other forces may change how future clinicians conduct clinical interviews; however, it is likely that clinical interviews will remain foundational to psychological assessment and treatment.
To investigate the percentage of patients who commenced smoking after transferring out of a non-smoking forensic psychiatric unit, the corresponding clozapine dose adjustments, the effects on plasma clozapine/norclozapine concentrations and observed changes in mental state. We reviewed the notes and plasma clozapine/norclozapine concentrations of 46 patients transferred to medium secure units between July 2008 and December 2013.
Thirty-five patients commenced smoking. Their median clozapine dose was increased by 50 mg/d. In the non-smokers, the median clozapine dose remained unchanged. Plasma clozapine/norclozapine concentrations were significantly reduced in smokers despite dosage adjustment. Eighteen patients experienced deterioration in mental state after transfer; almost all these patients were smokers.
Approximately three-quarters of patients who were non-smokers by virtue of being in a secure non-smoking environment commenced smoking after transfer. Monitoring of clozapine serum levels and assessment of mental state in the immediate period after a change in smoking status is indicated.
ALTHOUGH Arras MS 649 contains the fullest version of Herbert of Bosham's Vita S. Thomae, several abbreviated or otherwise incomplete versions being extant, it was not a particular interest in the archbishop's life and death which sent me to the text. Rather, I was in search of Herbert's own autobiographical interpolations, especially the one where he discusses doubts about the timing of the Incarnation. It was in the course of this enquiry that I became aware of the tangled tale of the missing leaves of Arras 649.
The fact that MS 649 had been mutilated is well known to scholars in the field, but the actual history of the excised leaves and such basic questions as their number and whereabouts at different times are the subject of conflicting accounts. Indeed there is a good deal of what might be thought of as mythology surrounding the story. The aim of this paper is to correct some widespread misapprehensions and to point up some bibliographical lessons along the way.
The preferred edition of Herbert's text of the Vita S. Thomae and its appendage the Liber Melorum is still that of James Craigie Robertson in volume three of Materials for the History of Thomas Becket, Archbishop of Canterbury. His edition supersedes that of John Allen Giles, published in Herberti de Boseham opera quae extant omnia, which text formed part of his ambitious series, the Patres Ecclesiae Anglicanae. It was the Giles edition that J.-P. Migne later appropriated, for the even less reliable version printed in volume 190 of the Patrologia Latina.
However, when I had ordered up Volume III of the Materials from the University of Adelaide Library I was disconcerted to find a line of asterisks at a crucial juncture of the text. They occur at the transition from Herbert's account of Thomas's decidedly brisk manner in getting through the mass to his own doubts about the Incarnation. It was at this point that I consulted Robertson's Introduction to the Materials in Volume I for an explanation of what had happened, and so began my search for the missing leaves of the Arras manuscript.
Considerable attention has focused on tactics firms use when building their sustainability platforms. Less is known, however, about how sustainability goal setting varies globally, especially in developing economies. Accordingly, we examined sustainability goals of 21 of the 50 largest Indian firms and compared them with similar data from a published study that examined 22 of the 50 largest U.S. firms. In total, 679 sustainability goals were analyzed using a triple bottom line framework. We found U.S. firms set more sustainability goals than Indian firms. Firms from both samples set similar numbers of people goals but U.S. firms set more diversity goals. Indian firms were more inclined to set economic and community development goals. We also detected differences across the samples in planet goals associated with emissions and water. Especially significant, Indian firms were much more likely than U.S. firms to specify profit goals. Implications for research and practice are discussed.
A Warren-Averbach1-4 X-ray line profile analysis was applied to broadened X-ray diffraction peaks from copper deformed in fatigue. The copper specimens were fatigued by four-point bending at peak-strain amplitudes between 0.00105 and 0.00442 in./in., and measurements were made at various fractions of the total fatigue life. The analysis results in an estimation of (a) an average coherently diffracting domain size normal to the diffracting planes and (b) an rms strain distribution function where the strain normal to the diffracting planes is averaged over a given distance at all points in the diffracting crystals and expressed as a function of averaging distance.
Prior to fatigue cycling, the annealed copper exhibited extinction, which reduced the integrated intensity from the low-angle reflections. After fatigue cycling, the integrated intensity increased with increasing strain amplitude of fatigue. The integrated intensities and the rms strains were established during the first few percent of the fatigue life and were found to increase with fatigue strain amplitude. The measured strains were larger in the <100> direction than in the <111> direction, but the absolute values were small. On the basis of transmission electron microscopy of thin foils, these results may be explained by assuming the strains are due to the presence of numerous dislocation dipoles.
Recent findings demonstrate a bilingual advantage for voice processing in children, but the mechanism supporting this advantage is unknown. Here we examined whether a bilingual advantage for voice processing is observed in adults and, if so, if it reflects enhanced pitch perception or inhibitory control. Voice processing was assessed for monolingual and bilingual adults using an associative learning identification task and a discrimination task in English (a familiar language) and French (an unfamiliar language). Participants also completed pitch perception, flanker, and auditory Stroop tasks. Voice processing was improved for the familiar compared to the unfamiliar language and reflected individual differences in pitch perception (both tasks) and inhibitory control (identification task). However, no bilingual advantage was observed for either voice task, suggesting that the bilingual advantage for voice processing becomes attenuated during maturation, with performance in adulthood reflecting knowledge of linguistic structure in addition to general auditory and inhibitory control abilities.
Finance management skills deteriorate early on in dementia, and can influence the ability to maintain control over personal affairs. The aim of this study was to assess the contributions of different types of cognition and motor functioning to finance management.
Cross-sectional analysis using secondary data.
Baseline data from the Uniform Data Set from the National Alzheimer's Coordinating Centers were obtained and extracted up until December 2016.
Measures on everyday functioning (Functional Assessment Questionnaire) and cognition (memory, executive functioning, and language), the Clinical Dementia Rating scale, and questions on Parkinsonian motor symptoms (gait disturbance, falls, tremors, and slowness) were included. Data were analyzed using bivariate correlation and linear regression analyses.
A total of 9,383 participants were included in the analysis (Alzheimers disease (AD) = 8,201; behavioral variant fronto-temporal dementia (bvFTD) = 796; Dementia with Lewy Bodies (DLB) = 386). Cognition and motor functioning varied significantly across AD, bvFTD, and DLB, with poorer motor functioning and poorer finance management skills in DLB than in AD and bvFTD. In the regression models, slowness, verbal fluency, executive functioning, and language, followed by age, gender, and diagnosis accounted for 13.8% of the variation in managing bills, and for 11.4% of the variation in managing taxes.
Maintaining finance management abilities for as long as possible is important for people with dementia, to avoid potential financial exploitation. Findings from this study highlight avenues to pursue to delay deterioration in managing bills and taxes, and help maintain financial control.
To date, Ireland has been a leading light in the provision of youth mental health services. However, cognisant of the efforts of governmental and non-governmental agencies working in youth mental health, there is much to be done. Barriers into care as well as discontinuity of care across the spectrum of services remain key challenges. This editorial provides guidance for the next stage of development in youth mental care and support that will require significant national engagement and resource investment.
Background: NEDA is a composite measure that may ultimately influence clinical decisions concerning switches of disease modifying therapy (DMT) for relapsing remitting multiple sclerosis (RRMS) patients. Cohort studies from MS clinics suggest NEDA is not sustained over time in most patients despite DMT but may be limited by referral bias. We investigated NEDA in a population-based RRMS cohort. Methods: We identified all incident cases of RRMS in Olmsted County from 01/01/2000-12/31/2011. Retrospective chart review was conducted to determine persistence of NEDA -following RRMS diagnosis. NEDA failure was defined as new MRI activity, relapse, or expanded disability status scale (EDSS) -worsening. Results: There were 93 incident cases of RRMS with 82 individuals having sufficient follow-up to determine persistence of NEDA. Prior to NEDA failure 44 were not on DMT, 37 were on first-tier, injectable DMT, and 1 received mitoxantrone. NEDA was maintained by 63% at 1 year, 38% at 2 years, 19% at 5 years, and 12% at 10 years. Disability measured by EDSS was no different at 10 years in patients maintaining NEDA versus those that failed NEDA at one year (p=0.3). Conclusions: Maintenance of NEDA beyond 2 years is infrequent among a population-based cohort of newly diagnosed RRMS patients and similar to prior clinic-based cohorts.
High-dose vitamin A supplementation (VAS) may affect mortality to infectious diseases in a sex-differential manner. Here, we analysed the long-term immunological effects of neonatal vitamin A supplementation (NVAS) in 247 children, who had been randomly allocated to 50 000 or 25 000 IU vitamin A (15mg and 7·5mg retinol equivalents, respectively) or placebo at birth. At 4–6 months of age, we assessed bacille Calmette–Guérin (BCG) scarification, and we analysed in vitro responses of TNF-α, IL-5, IL-10, IL-13 and IFN-γ in whole blood stimulations to phytohaemagglutinin (PHA), purified protein derivative (PPD), tetanus toxoid and lipopolysaccharide. There were no differences between the two doses of NVAS, and thus they were analysed combined as NVAS (any dose) v. placebo. All analyses were performed unstratified and by sex. NVAS increased the chance of having a scar after BCG vaccination in females (NVAS v. placebo: 96 v. 71 %, proportion ratio: 1·24; 95 % CI 1·09, 1·42), but not in males (Pfor interaction=0·012). NVAS was associated with significant sex-differential effects on the pro- to anti-inflammatory cytokine ratios (TNF-α:IL-10) to PPD, tetanus toxoid and medium alone, which were increased in females but decreased in males. In addition, IL-17 responses tended to be increased in NVAS v. placebo recipients in males but not in females, significantly so for the PHA stimulation. The study corroborates sex-differential effects of VAS on the immune system, emphasising the importance of analysing VAS effects by sex.
In mid season prime lamb production Keady and Hanrahan (2006) concluded that increasing litter size and good grassland management are the main factors affecting efficiency of production. Nolan (1972) reported lamb carcass outputs of 203 and 301 kg/ha from grass-based systems which received 77 kg N/ha and were stocked with 10 and 15 Galway ewes (mean litter size of 1.4 lambs) per hectare, respectively. Subsequently the Belclare breed was developed (Hanrahan 1997) as a genetic resource for increased prolificacy. Recently there has been interest in either reducing or eliminating the winter indoor feeding period by extended grazing. Recent studies at this Centre have shown that extended grazing in mid, late or throughout pregnancy increased lamb birth and weaning weights relative to progeny from ewes which have been housed unshorn (Keady et al 2007). The primary objective of this study was to evaluate two contrasting grass-based systems for prime lamb production. The systems adopted compared maintaining the stocking rates and levels of fertilizer nitrogen application similar to that of Nolan (1972) but increasing lamb carcass output through improved genetic capacity and either housing the flock during the winter period or maximising the use of grazed grass by year round grazing. Two ewe genotypes were used to examine if there were any interactions between level of prolifacy and the grassland based system of production adopted.
A pulsar-monitoring programme has been running at Hartebeesthoek Radio Astronomy Observatory over the last three years, at 2.32 and (during the last year) at 1.67 GHz. Twenty pulsars are observed once or twice a fortnight, and PSRs 1641-45 and 0833-45 (the Vela pulsar) daily.
Field studies were initiated in the 2013-14 and 2014-15 growing seasons to evaluate the potential of soil solarization (SS) treatments for their efficacy on weed control and crop yields and to compare SS to 1,3-dichloropropene (1,3-D)+chloropicrin (Pic) fumigation. Each replicate was a bed with dimension 10.6 m long by 0.8 m wide on top. The center 4.6 m length of each bed, referred to as plots, was used for strawberry plug transplanting and data collection. Treatments included: i) 1,3-D+Pic (39% 1,3-dichloropropene+59.6% chloropicrin) that was shank-fumigated in beds at 157 kg ha−1 and covered with VIF on August 30 in both seasons; ii) SS for a 6 wk duration initiated on August 15, 2013 and August 21, 2014 by covering the bed with 1 mil clear polyethylene tarp; iii) SS for a 4wk duration initiated on September 6, 2013 and September 3, 2014; iv) SS 4 wk treatment initiated September 6, 2013 and September 3, 2014 and replaced with black VIF on October 4, 2013 and October 1, 2014 and v) a nontreated control covered with black VIF on October 4, 2013 and October 1, 2014. In both seasons, following completion of the preplant treatments, ‘Chandler’ strawberry was planted in two rows at a 36 cm in-row spacing in plots during the first wk of October. Over both seasons, the 6 wk SS treatment consistently lowered the weed density compared to the nontreated control. Weed density in the 6wk SS treatment was not statistically different from the 4wk SS treatments in the 2013-14 growing season. In both seasons, crop yield in the 4 wk SS was significantly lower than other treatments.