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This paper reports on: (1) an evaluation of a common elements treatment approach (CETA) developed for comorbid presentations of depression, anxiety, traumatic stress, and/or externalizing symptoms among children in three Somali refugee camps on the Ethiopian/Somali border, and (2) an evaluation of implementation factors from the perspective of staff, lay providers, and families who engaged in the intervention.
This project was conducted in three refugee camps and utilized locally validated mental health instruments for internalizing, externalizing, and posttraumatic stress (PTS) symptoms. Participants were recruited from either a validity study or from referrals from social workers within International Rescue Committee Programs. Lay providers delivered CETA to youth (CETA-Youth) and families, and symptoms were re-assessed post-treatment. Providers and families responded to a semi-structured interview to assess implementation factors.
Children who participated in the CETA-Youth open trial reported significant decreases in symptoms of internalizing (d = 1.37), externalizing (d = 0.85), and posttraumatic stress (d = 1.71), and improvements in well-being (d = 0.75). Caregivers also reported significant decreases in child symptoms. Qualitative results were positive toward the acceptability and appropriateness of treatment, and its feasibility.
This project is the first to examine a common elements approach (CETA: defined as flexible delivery of elements, order, and dosing) with children and caregivers in a low-resource setting with delivery by lay providers. CETA-Youth may offer an effective treatment that is easier to implement and scale-up versus multiple focal interventions. A fullscale randomized clinical trial is warranted.
After the diagnosis of immune-mediated inflammatory diseases (IMID) such as inflammatory bowel disease (IBD), multiple sclerosis (MS) and rheumatoid arthritis (RA), the incidence of psychiatric comorbidity is increased relative to the general population. We aimed to determine whether the incidence of psychiatric disorders is increased in the 5 years before the diagnosis of IMID as compared with the general population.
Using population-based administrative health data from the Canadian province of Manitoba, we identified all persons with incident IBD, MS and RA between 1989 and 2012, and cohorts from the general population matched 5 : 1 on year of birth, sex and region to each disease cohort. We identified members of these groups with at least 5 years of residency before and after the IMID diagnosis date. We applied validated algorithms for depression, anxiety disorders, bipolar disorder, schizophrenia, and any psychiatric disorder to determine the annual incidence of these conditions in the 5-year periods before and after the diagnosis year.
We identified 12 141 incident cases of IMID (3766 IBD, 2190 MS, 6350 RA) and 65 424 matched individuals. As early as 5 years before diagnosis, the incidence of depression [incidence rate ratio (IRR) 1.54; 95% CI 1.30–1.84) and anxiety disorders (IRR 1.30; 95% CI 1.12–1.51) were elevated in the IMID cohort as compared with the matched cohort. Similar results were obtained for each of the IBD, MS and RA cohorts. The incidence of bipolar disorder was elevated beginning 3 years before IMID diagnosis (IRR 1.63; 95% CI 1.10–2.40).
The incidence of psychiatric comorbidity is elevated in the IMID population as compared with a matched population as early as 5 years before diagnosis. Future studies should elucidate whether this reflects shared risk factors for psychiatric disorders and IMID, a shared final common inflammatory pathway or other aetiology.
Self-report measurement instruments are commonly used to screen for mental health disorders in Low and Middle-Income Countries (LMIC). The Western origins of most depression instruments may constitute a bias when used globally. Western measures based on the DSM, do not fully capture the expression of depression globally. We developed a self-report scale design to address this limitation, the International Depression Symptom Scale-General version (IDSS-G), based on empirical evidence of the signs and symptoms of depression reported across cultures. This paper describes the rationale and process of its development and the results of an initial test among a non-Western population.
We evaluated internal consistency reliability, test–retest reliability and inter-rater reliability of the IDSS-G in a sample N = 147 male and female attendees of primary health clinics in Yangon, Myanmar. For criterion validity, IDSS-G scores were compared with diagnosis by local psychiatrists using the Structured Clinical Interview for DSM (SCID). Construct validity was evaluated by investigating associations between the IDSS-G and the Patient Health Questionnaire (PHQ), impaired function, and suicidal ideation.
The IDSS-G showed high internal consistency reliability (α = 0.92), test–retest reliability (r = 0.87), and inter-rater reliability (ICC = 0.90). Strong correlations between the IDSS-G and PHQ-9, functioning, and suicidal ideation supported construct validity. Criterion validity was supported for use of the IDSS-G to identify people with a SCID diagnosed depressive disorder (major depression/dysthymia). The IDSS-G also demonstrated incremental validity by predicting functional impairment beyond that predicted by the PHQ-9. Results suggest that the IDSS-G accurately assesses depression in this population. Future testing in other populations will follow.
We describe the performance of the Boolardy Engineering Test Array, the prototype for the Australian Square Kilometre Array Pathfinder telescope. Boolardy Engineering Test Array is the first aperture synthesis radio telescope to use phased array feed technology, giving it the ability to electronically form up to nine dual-polarisation beams. We report the methods developed for forming and measuring the beams, and the adaptations that have been made to the traditional calibration and imaging procedures in order to allow BETA to function as a multi-beam aperture synthesis telescope. We describe the commissioning of the instrument and present details of Boolardy Engineering Test Array’s performance: sensitivity, beam characteristics, polarimetric properties, and image quality. We summarise the astronomical science that it has produced and draw lessons from operating Boolardy Engineering Test Array that will be relevant to the commissioning and operation of the final Australian Square Kilometre Array Path telescope.
Tuberous sclerosis complex (TSC) is associated with intellectual disability, but the risk pathways are poorly understood.
The Tuberous Sclerosis 2000 Study is a prospective longitudinal study of the natural history of TSC. One hundred and twenty-five UK children age 0–16 years with TSC and born between January 2001 and December 2006 were studied. Intelligence was assessed using standardized measures at ≥2 years of age. The age of onset of epilepsy, the type of seizure disorder, the frequency and duration of seizures, as well as the response to treatment was assessed at interview and by review of medical records. The severity of epilepsy in the early years was estimated using the E-Chess score. Genetic studies identified the mutations and the number of cortical tubers was determined from brain scans.
TSC2 mutations were associated with significantly higher cortical tuber count than TSC1 mutations. The extent of brain involvement, as indexed by cortical tuber count, was associated with an earlier age of onset and severity of epilepsy. In turn, the severity of epilepsy was strongly associated with the degree of intellectual impairment. Structural equation modelling supported a causal pathway from genetic abnormality to cortical tuber count to epilepsy severity to intellectual outcome. Infantile spasms and status epilepticus were important contributors to seizure severity.
The findings support the proposition that severe, early onset epilepsy may impair intellectual development in TSC and highlight the potential importance of early, prompt and effective treatment or prevention of epilepsy in tuberous sclerosis.
This paper describes the system architecture of a newly constructed radio telescope – the Boolardy engineering test array, which is a prototype of the Australian square kilometre array pathfinder telescope. Phased array feed technology is used to form multiple simultaneous beams per antenna, providing astronomers with unprecedented survey speed. The test array described here is a six-antenna interferometer, fitted with prototype signal processing hardware capable of forming at least nine dual-polarisation beams simultaneously, allowing several square degrees to be imaged in a single pointed observation. The main purpose of the test array is to develop beamforming and wide-field calibration methods for use with the full telescope, but it will also be capable of limited early science demonstrations.
Evidence suggests some overlap between the pathological use of food and drugs, yet how impulsivity compares across these different clinical disorders remains unclear. Substance use disorders are commonly characterized by elevated impulsivity, and impulsivity subtypes may show commonalities and differences in various conditions. We hypothesized that obese subjects with binge-eating disorder (BED) and abstinent alcohol-dependent cohorts would have relatively more impulsive profiles compared to obese subjects without BED. We also predicted decision impulsivity impairment in obesity with and without BED.
Thirty obese subjects with BED, 30 without BED and 30 abstinent alcohol-dependent subjects and age- and gender-matched controls were tested on delay discounting (preference for a smaller immediate reward over a larger delayed reward), reflection impulsivity (rapid decision making prior to evidence accumulation) and motor response inhibition (action cancellation of a prepotent response).
All three groups had greater delay discounting relative to healthy volunteers. Both obese subjects without BED and alcohol-dependent subjects had impaired motor response inhibition. Only obese subjects without BED had impaired integration of available information to optimize outcomes over later trials with a cost condition.
Delay discounting appears to be a common core impairment across disorders of food and drug intake. Unexpectedly, obese subjects without BED showed greater impulsivity than obese subjects with BED. We highlight the dissociability and heterogeneity of impulsivity subtypes and add to the understanding of neurocognitive profiles across disorders involving food and drugs. Our results have therapeutic implications suggesting that disorder-specific patterns of impulsivity could be targeted.
Substantial overlap has been reported between attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Deficits in executive function (EF) are characteristic of both disorders but these impairments have not been compared directly across pure and co-morbid cases using event-related potentials (ERPs).
Behavioural parameters and ERPs were recorded during a flankered cued-continuous performance test (CPT-OX) administered to 8–13-year-old boys with ASD (n = 19), ADHD (n = 18), co-morbid ASD + ADHD (n = 29) and typically developing controls (TD; n = 26). Preparatory processing (contingent negative variation, CNV) and attentional orienting (Cue-P3) at cues, response execution at targets (Go-P3), inhibitory processing at non-targets (NoGo-P3) and conflict monitoring between target and non-target trials (Go-N2 v. NoGo-N2) were examined.
Categorical diagnoses and quantitative trait measures indicated that participants with ADHD (ADHD/ASD + ADHD) made more omission errors and exhibited increased reaction-time (RT) variability and reduced amplitude of the Cue-P3 and NoGo-P3 compared to TD/ASD participants. Participants with ASD (ASD/ ASD + ADHD) demonstrated reduced N2 enhancement from Go to NoGo trials compared to TD/ADHD participants. Participants with ASD-only displayed enhanced CNV amplitude compared to ASD + ADHD and TD participants.
Children with ADHD show deficits in attentional orienting and inhibitory control whereas children with ASD show abnormalities in conflict monitoring and response preparation. Children with co-morbid ASD + ADHD present as an additive co-occurrence with deficits of both disorders, although non-additive effects are suggested for response preparation. Measuring ERPs that index attention and inhibition is useful in disentangling cognitive markers of ASD and ADHD and elucidating the basis of co-occurring ASD + ADHD to guide clinical assessment.
Although it has been posited that exposure to adverse childhood experiences (ACEs) increases vulnerability to deployment stress, previous literature in this area has demonstrated conflicting results. Using a cross-sectional population-based sample of active military personnel, the present study examined the relationship between ACEs, deployment related stressors and mood and anxiety disorders.
Data were analyzed from the 2002 Canadian Community Health Survey – Canadian Forces Supplement (CCHS-CFS; n = 8340, age 18–54 years, response rate 81%). The following ACEs were self-reported retrospectively: childhood physical abuse, childhood sexual abuse, economic deprivation, exposure to domestic violence, parental divorce/separation, parental substance abuse problems, hospitalization as a child, and apprehension by a child protection service. DSM-IV mood and anxiety disorders [major depressive disorder, post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic attacks/disorder and social phobia] were assessed using the Composite International Diagnostic Interview (CIDI).
Even after adjusting for the effects of deployment-related traumatic exposures (DRTEs), exposure to ACEs was significantly associated with past-year mood or anxiety disorder among men [adjusted odds ratio (aOR) 1.34, 99% confidence interval (CI) 1.03–1.73, p < 0.01] and women [aOR 1.37, 99% CI 1.00–1.89, p = 0.01]. Participants exposed to both ACEs and DRTEs had the highest prevalence of past-year mood or anxiety disorder in comparison to those who were exposed to either ACEs alone, DRTEs alone, or no exposure.
ACEs are associated with several mood and anxiety disorders among active military personnel. Intervention strategies to prevent mental health problems should consider the utility of targeting soldiers with exposure to ACEs.
The purpose of this study was to determine the presence of thermophilic
and Salmonella spp. in sand from non-EEC standard and EEC standard
designated beaches in
different locations in the UK and to assess if potentially pathogenic strains
Campylobacter spp. were detected in 82/182 (45%) of sand samples
and Salmonella spp. in
10/182 (6%). Campylobacter spp. were isolated from 46/92
(50%) of samples from non-EEC
standard beaches and 36/90 (40%) from EEC standard beaches. The prevalence
Campylobacter spp. was greater in wet sand from both types of
beaches but, surprisingly, more
than 30% of samples from dry sand also contained these organisms. The major
species C. jejuni and C. coli were more prevalent in
sand from non-EEC standard beaches. In
contrast, C. lari and urease positive thermophilic campylobacters,
which are associated with
seagulls and other migratory birds, were more prevalent in sand from EEC
Campylobacter isolates were further characterized by biotyping and serotyping,
confirmed that strains known to be of types associated with human infections
found in sand on bathing beaches.
A study was made of ants in Sri Lankan coconut plantations, especially of species foraging and nesting in palm crowns. At least 11 species were found nesting in the spadices, and a special study was made of interactions between some likely to be insect egg predators or to interfere with predation. Oecophylla smaragdina (F.) and Paratrechina longicornis (Latreille) were mutually exclusive, but some non-dominant species such as Monomorium spp. commonly nested and foraged in palms occupied by large populations of dominants such as O. smaragdina and Crematogaster sp. Eggs of the coconut pest Opisina arenosella Walker (and of Corcyra cephalonica (Stainton), which were used to simulate the former on palm fronds) were rapidly found and removed by certain ant species, notably M. floricola (Jerdan) and Crematogaster sp. Oecophylla smaragdina and P. longicornis seemed erratic as egg predators. Surveys of ants in areas where Opisina arenosella does, and does not, develop to outbreak populations showed that Monomorium spp. in particular were notably more common in the non-outbreak areas. However, other ants, notably Technomyrmex albipes (F. Smith), were sometimes common in outbreak areas and were seemingly good egg predators. The presence of thriving Oecophylla smaragdina colonies on currently attacked palms shows that this otherwise well-recognized predator has little or no effect on Opisina arenosella. It is concluded that several species of ants which nest in coconut palm crowns probably contribute importantly to the mortality of eggs of O. arenosella and help keep it in its rare endemic state in most places most of the time, even in outbreak areas.
The epidemiology of influenza in the hospital is frequently confounded by failure to separate community-acquired from nosocomial transmission. An 83-year-old woman was hospitalized one day after returning from Asia with complications resulting from acute influenza A (H3N2) infection; she was the first culture-confirmed case in the region during the 1987-1988 influenza season, and her illness antedated other influenza cases in the area by at least four weeks. The patient shed virus at least four days after admission and transmitted influenza to her primary physician; both had received trivalent influenza vaccine four weeks earlier. Surveillance data from the 28 health care providers (HCPs) in contact with the index case (mean age: 34.5 years; median time of contact: four hours, none receiving vaccine) revealed no evidence of transmission as detected by paired type-specific complement-fixation antibodies and throat culture (20 subjects) or acute serologies and culture (7 subjects). No febrile respiratory illnesses were detected among other patients on the same ward, although three were reported among HCPs. Thus, neither secondary spread of influenza from infected patient to hospital HCPs nor nosocomial transmission apparently took place, although transmission did occur to the primary physician.
We have measured the microwave-induced damage to the near-surface region of a graphite/epoxy composite material for 1.1-μs pulses at a frequency of 2.856 GHz and a pulse power of up to 8 MW. Rectangular samples were irradiated by single-pass TE10 traveling wave pulses inside a WR-284 waveguide, and in situ and post irradiation studies were performed to characterize the material modifications induced by the microwave pulses. The results of the time-resolved optical measurements in vacuo show that surface decomposition of the epoxy resin occurs for incident pulse powers exceeding 1.1 MW, and that the surface damage is accompanied by a large increase in the reflected microwave power. Simultaneous with the onset of surface decomposition, significant light emission from the sample and a large enhancement of the gas pressure in the test cell were observed. The large increments in both the reflected power and light emission are attributed to the formation of a plasma due to electrical breakdown of the gas at (or near) the sample surface.
We have used 1.1-μs microwave pulses at a frequency of 2.856 GHz to rapidly heat the near-surface region of arsenic-implanted silicon. The samples were irradiated inside a WR-284 waveguide by single-pass TE10 traveling wave pulses. Post-irradiation studies show that surface melting occurs for incident pulse powers exceeding about 3 MW. Time-resolved measurements of the microwave reflectivity (R) show that there is an abrupt and large increase in R for microwave pulse powers greater than the melt threshold. Significant light emission was also observed from the test cell, which is most likely due to the relaxation of a microwave-induced plasma formed by electrical breakdown of gas. Using secondary ion mass spectrometry, we measured the depth profile of the implanted arsenic and found that the penetration of the melt front in the near-surface region is not spatially homogeneous over the silicon surface.
We have measured the microwave-induced damage to the near-surface region of silicon for 1.9-μs pulses at a frequency of 2.856 GHz and a pulse power of up to 7.2 MW. Rectangular samples were irradiated in a test section of WR-284 waveguide that was filled with freon to a pressure of 30 psig. Incident, transmitted and reflected powers were monitored with directional couplers and fast diodes. The results of the time-resolved optical measurements show that the onset of surface damage is accompanied by a large increase in the reflected power. Examination of the irradiated surfaces shows that the degree of damage is greatest near the edges of the samples. Using secondary ion mass spectrometry to profile the implanted As, we find that the microwave pulses can melt the near-surface region of the material for pulse powers exceeding a threshold value.
The present account refers mainly to research work published in the period 1973–1975. Due to the limited space available, and the rapidly increasing number of contributions in the field of Commission. 28, it has not been possible to write an all-inclusive report. As in the previous IAU volumes, the report is not intended as a repetition of the summaries given in the Astronomy and Astrophysics Abstracts. In stressing the importance of certain areas of research, the personal views of the writer(s) cannot be entirely avoided.
During the generation before the French Revolution, die Atlantic colonial powers - Britain, France, Spain - endeavoured in various ways to assert metropolitan control of trade and expansion in the colonies. The revolt of Britain's American colonies was the most spectacular failure of such policies, but it did not deter eidier London or Versailles after the peace of 1783 from continuing to seek a more active supervision of their colonial outposts. Among symptoms of this activity were the energetic policies of die French ministry of marine under Castries, and the creation of the Board of Control for India and the renovated Board of Trade under Pitt
Symptoms of magnesium deficiency and take-all disease occurred during 1967 in wheat grown for the second year in succession on the ‘Classical’ cereal site at Woburn. Magnesium fertilizers, which cured the deficiency symptoms and increased wheat yields in 1968 and 1969, had no effect on take-all. Leaves from crops severely attacked by take-all contained less nitrogen and potassium than leaves from unattacked plants but not less magnesium. In 1969 magnesium fertilizer did not increase yields or affect takeall of spring barley on the site but, in contrast to 1968, increased potato yields. Magnesium fertilizer improved the establishment of clover, especially on soil containing least magnesium.
Soil analyses show a tenfold decline in exchangeable Mg since 1888. Losses were most from soil given ammonium sulphate and more from the site where wheat was long grown than where barley was. Differences in soil magnesium did not explain large differences in yields of potatoes or leys between blocks of the experiments.
During the course of a survey for radio sources using a sea interferometer changes in the apparent intensity of the source Hydra A were observed. The intensities on two consecutive days differed by more than 30 % although the intensities of sources appearing earlier and later on the same records showed no significant changes. The position of this source given by Mills (1952)  is r.a. 09h 15m 46s, dec. − 11° 55′ (epoch 1950) and its I.A.U. number 09S1A.