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The period before the formation of a persecutory delusion may provide causal insights. Patient accounts are invaluable in informing this understanding.
To inform the understanding of delusion formation, we asked patients about the occurrence of potential causal factors – identified from a cognitive model – before delusion onset.
A total of 100 patients with persecutory delusions completed a checklist about their subjective experiences in the weeks before belief onset. The checklist included items concerning worry, images, low self-esteem, poor sleep, mood dysregulation, dissociation, manic-type symptoms, aberrant salience, hallucinations, substance use and stressors. Time to reach certainty in the delusion was also assessed.
Most commonly it took patients several months to reach delusion certainty (n = 30), although other patients took a few weeks (n = 24), years (n = 21), knew instantly (n = 17) or took a few days (n = 6). The most frequent experiences occurring before delusion onset were: low self-confidence (n = 84); excessive worry (n = 80); not feeling like normal self (n = 77); difficulties concentrating (n = 77); going over problems again and again (n = 75); being very negative about the self (n = 75); images of bad things happening (n = 75); and sleep problems (n = 75). The average number of experiences occurring was high (mean 23.5, s.d. = 8.7). The experiences clustered into six main types, with patients reporting an average of 5.4 (s.d. = 1.0) different types.
Patients report numerous different experiences in the period before full persecutory delusion onset that could be contributory causal factors, consistent with a complex multifactorial view of delusion occurrence. This study, however, relied on retrospective self-report and could not determine causality.
The National Institute for Health and Care Excellence referral guidelines prompting urgent two-week referrals were updated in 2015. Additional symptoms with a lower threshold of 3 per cent positive predictive values were integrated. This study aimed to examine whether current pan-London urgent referral guidelines for suspected head and neck cancer lead to efficient and accurate referrals by assessing frequency of presenting symptoms and risk factors, and examining their correlation with positive cancer diagnoses.
The risk factors and symptoms of 984 consecutive patients (over a six-month period in 2016) were collected retrospectively from urgent referral letters to University College London Hospital for suspected head and neck cancer.
Only 37 referrals (3.76 per cent) resulted in a head and neck cancer diagnosis. Four of the 23 recommended symptoms demonstrated statistically significant results. Nine of the 23 symptoms had a positive predictive value of over 3 per cent.
The findings indicate that the current referral guidelines are not effective at detecting patients with cancer. Detection rates have decreased from 10–15 per cent to 3.76 per cent. A review of the current head and neck cancer referral guidelines is recommended, along with further data collection for comparison.
The diurnal feeding patterns of dairy cows affects the 24 h robot utilisation of pasture-based automatic milking systems (AMS). A decline in robot utilisation between 2400 and 0600 h currently occurs in pasture-based AMS, as cow feeding activity is greatly reduced during this time. Here, we investigate the effect of a temporal variation in feed quality and quantity on cow feeding behaviour between 2400 and 0600 h as a potential tool to increase voluntary cow trafficking in an AMS at night. The day was allocated into four equal feeding periods (0600 to 1200, 1200 to 1800, 1800 to 2400 and 2400 to 0600 h). Lucerne hay cubes (CP = 19.1%, water soluble carbohydrate = 3.8%) and oat, ryegrass and clover hay cubes with 20% molasses (CP = 11.8%, water soluble carbohydrate = 10.7%) were offered as the ‘standard’ and ‘preferred’ (preference determined previously) feed types, respectively. The four treatments were (1) standard feed offered ad libitum (AL) throughout 24 h; (2) as per AL, with preferred feed replacing standard feed between 2400 and 0600 h (AL + P); (3) standard feed offered at a restricted rate, with quantity varying between each feeding period (20:10:30:60%, respectively) as a proportion of the (previously) measured daily ad libitum intake (VA); (4) as per VA, with preferred feed replacing standard feed between 2400 and 0600 h (VA + P). Eight non-lactating dairy cows were used in a 4 × 4 Latin square design. During each experimental period, treatment cows were fed for 7 days, including 3 days habituation and 4 days data collection. Total daily intake was approximately 8% greater (P < 0.001) for the AL and AL + P treatments (23.1 and 22.9 kg DM/cow) as compared with the VA and VA + P treatments (21.6 and 20.9 kg DM/cow). The AL + P and VA treatments had 21% and 90% greater (P < 0.001) dry matter intake (DMI) between 2400 and 0600 h, respectively, compared with the AL treatment. In contrast, the VA + P treatment had similar DMI to the VA treatment. Our experiment shows ability to increase cow feeding activity at night by varying feed type and quantity, though it is possible that a penalty to total DMI may occur using VA. Further research is required to determine if the implementation of variable feed allocation on pasture-based AMS farms is likely to improve milking robot utilisation by increasing cow feeding activity at night.
Open dialogue is an integrative approach to the organisation of specialist mental health services and therapeutic meetings.
This qualitative study sought to explore service users' and clinicians’ experiences of network meetings during the implementation of open dialogue in a modified version, for a UK-based mental health service.
In total 19 participants were interviewed (8 service users and 11 clinicians) and an inductive thematic analysis of the data was conducted.
Four dominant themes were identified: (1) open dialogue delivery, (2) the impact of open dialogue principles; (3) intense interactions and enhanced communication, and (4) organisational challenges. Clinicians considered open dialogue as a preferred, but challenging way of working, while being therapeutic. The data indicated that service users' experiences of network meetings were mixed. There was a wide variety of service user views as to what the purpose of a network meeting was and for some witnessing reflective conversations felt strange. However, the majority described feeling listened to and understood, excluding one service user who described their experience as distressing. Clinicians expressed an authentic self in their interactions with service users and both service users and clinicians described network meetings as emotionally expressive, although this was described as overwhelming at times.
The results of this thematic analysis indicate that service users' and clinicians’ experiences of open dialogue warrant further investigation. The intensity of interactions in network meetings should be carefully considered with service users before gaining consent to commence treatment. Implementation of open dialogue should be monitored to assess clinician- and service-level adherence to the principles of the approach.
The cognitive process of worry, which keeps negative thoughts in mind and elaborates the content, contributes to the occurrence of many mental health disorders. Our principal aim was to develop a straightforward measure of general problematic worry suitable for research and clinical treatment. Our secondary aim was to develop a measure of problematic worry specifically concerning paranoid fears.
An item pool concerning worry in the past month was evaluated in 250 non-clinical individuals and 50 patients with psychosis in a worry treatment trial. Exploratory factor analysis and item response theory (IRT) informed the selection of scale items. IRT analyses were repeated with the scales administered to 273 non-clinical individuals, 79 patients with psychosis and 93 patients with social anxiety disorder. Other clinical measures were administered to assess concurrent validity. Test-retest reliability was assessed with 75 participants. Sensitivity to change was assessed with 43 patients with psychosis.
A 10-item general worry scale (Dunn Worry Questionnaire; DWQ) and a five-item paranoia worry scale (Paranoia Worries Questionnaire; PWQ) were developed. All items were highly discriminative (DWQ a = 1.98–5.03; PWQ a = 4.10–10.7), indicating small increases in latent worry lead to a high probability of item endorsement. The DWQ was highly informative across a wide range of the worry distribution, whilst the PWQ had greatest precision at clinical levels of paranoia worry. The scales demonstrated excellent internal reliability, test-retest reliability, concurrent validity and sensitivity to change.
The new measures of general problematic worry and worry about paranoid fears have excellent psychometric properties.
Local attitudes towards carnivores often reflect the degree of damage they are perceived to cause. Consequently, understanding the interactions between people and these species is essential to conservation efforts. This study investigated local perceptions of three Cerrado canid species and current chicken management practices, to identify the potential damage they cause and how this relates to peoples’ attitudes towards these species. Results from structured interviews at 50 ranches in Goiás, Brazil, highlighted that general knowledge about Cerrado canids differed significantly by species, with interviewees unable to correctly answer questions about the hoary fox Lycalopex vetulus and crab-eating fox Cerdocyon thous in comparison to the maned wolf Chrysocyon brachyurus. Chicken coops were identified as the most effective method for preventing predation, yet only 44% of respondents employed this method. Using a perceived predation measure, interviewees reported chicken predation by all three Cerrado canids even though most of these events were stated to occur during the day, outside the species’ active periods. Reported predation events were a strong predictor of attitude. Participants who experienced predation events reported they did not like having a Cerrado canid on their property. However, 86% of the respondents agreed that Cerrado canids should nevertheless be protected. Our findings support the need to incorporate the human dimension in canid and broader carnivore conservation issues.
Achieving a consistent level of robot utilisation throughout 24 h maximises automatic milking system (AMS) utilisation. However, levels of robot utilisation in the early morning hours are typically low, caused by the diurnal feeding behaviour of cows, limiting the inherent capacity and total production of pasture-based AMS. Our objective was to determine robot utilisation throughout 24 h by dairy cows, based on milking frequency (MF; milking events per animal per day) in a pasture-based AMS. Milking data were collected from January and February 2013 across 56 days, from a single herd of 186 animals (Bos taurus) utilising three Lely A3 robotic milking units, located in Tasmania, Australia. The dairy herd was categorised into three equal sized groups (n=62 per group) according to the cow’s mean daily MF over the duration of the study. Robot utilisation was characterised by an interaction (P< 0.001) between the three MF groups and time of day, with peak milking time for high MF cows within one h of a fresh pasture allocation becoming available, followed by the medium MF and low MF cows 2 and 4 h later, respectively. Cows in the high MF group also presented for milking between 2400 and 0600 h more frequently (77% of nights), compared to the medium MF group (57%) and low MF group (50%). This study has shown the formation of three distinct groups of cows within a herd, based on their MF levels. Further work is required to determine if this finding is replicated across other pasture-based AMS farms.
This school-based study reports on the development and preliminary analysis of the new pictorial semi-structured Child Anxiety and Coping Interview (CACI). Participants included 195 children (Mage = 6.71; SDage = .76) drawn from 29 primary schools located in Western Sydney, Australia. The study used a mixed qualitative and quantitative design. The CACI was used to elicit the children's self-report on their problems, emotions, coping strategies, and coping self-efficacy. Qualitative content and thematic analysis were used to code the children's nominated coping strategies for their problems in the home and school contexts. The top five most common problems reported were as follows: fear of spiders or insects, fear of the dark, going places without parents, doing badly at school, and heights. The top five most common coping strategies reported by the children were support seeking, behavioural avoidance, solving the problem, facing the challenge, and behavioural distraction. Self-reported negative emotional intensity was highest for fear of the dark. Coping self-efficacy for fear of the dark was also high, suggesting the children found their coping strategies helpful, including those that were maladaptive. The clinical implications of these findings are discussed.
This study examined the effects of a school-based cognitive-behavioural group intervention for anxiety in young children, Get Lost Mr Scary, on child self-reported anxiety and coping skills. Participants included 65 children (Mage = 6.50 years, SDage = 0.75) drawn from 13 public primary schools located in Western Sydney, Australia. The children participated in seven weekly 1-hour Get Lost Mr Scary sessions, and their parents attended three information sessions. The pictorial semistructured Child Anxiety and Coping Interview (CACI) was used to elicit the children's self-report of their anxiety symptoms, emotions, coping strategies, and coping efficacy before and after the 7-week intervention. Although children rated their maladaptive coping strategies as helpful, the postintervention results indicated a significant decrease in the use of maladaptive strategies such as behavioural avoidance and an increase in adaptive cognitive strategies, particularly cognitive restructuring. Consistent with parent and teacher reports, child self-reports indicated a significant reduction in anxiety and negative emotional distress. The clinical implications of the findings are discussed.
What Australian psychologists currently learn about specific learning disorders (SLDs) through postgraduate-level training is not clear. Accordingly, the current Australia-wide study analysed 800 postgraduate psychology unit handbook entries to identify which courses teach about SLD and what they teach in this area. Only 2.38% of the identified units explicitly indicated SLD-related content, with 0.38% solely dedicated to SLD content. Descriptive analyses revealed differences in labels used for SLD. Thematic analyses identified five areas of knowledge and skills across SLD units including assessment, intervention, theory and empirical evidence, developmental and cultural awareness and sensitivity, and interpersonal communication. The present findings can inform future refinements to university-level psychology programs across Australia by highlighting the gaps and needs in psychology training.
We present observations of 50 deg2 of the Mopra carbon monoxide (CO) survey of the Southern Galactic Plane, covering Galactic longitudes l = 300–350° and latitudes |b| ⩽ 0.5°. These data have been taken at 0.6 arcmin spatial resolution and 0.1 km s−1spectral resolution, providing an unprecedented view of the molecular clouds and gas of the Southern Galactic Plane in the 109–115 GHz J = 1–0 transitions of 12CO, 13CO, C18O, and C17O.
We present a series of velocity-integrated maps, spectra, and position-velocity plots that illustrate Galactic arm structures and trace masses on the order of ~106 M⊙ deg−2, and include a preliminary catalogue of C18O clumps located between l = 330–340°. Together with the information about the noise statistics of the survey, these data can be retrieved from the Mopra CO website and the PASA data store.
Why are globular clusters so important for astronomy? Here are some reasons. (i) Globular clusters are the oldest luminous objects in the Galaxy. They are samples from the early chemical evolution of the Galaxy, as the metal abundance [m/H] rose from about -2.5 to about -0.5. (ii) They are large enough to give a statistically significant data set for stellar evolution studies over this whole abundance range. (iii) Their stellar dynamics is very inviting; globular clusters are relatively simple structurally, so there seems to be a real opportunity for a fairly complete understanding of their internal dynamics. (iv) Some of their chemical and dynamical problems are similar to those of galaxies (eg the large clusters 47 Tuc and ω Cen show galaxy-like radial abundance gradients). These problems are much more tractable for globular clusters, because we can measure directly the chemical abundances and kinematics of individual cluster stars.
What are the characteristic scale lengths and densities for the dark halos of galaxies, and the typical ratios of dark to luminous mass? For elliptical galaxies, the best estimates come from X-ray data which will be discussed in a later session. For spirals, the best estimates come from rotation curves. I will concentrate on the halo parameters for disk galaxies. At the end, there will be a few comments on stellar dynamical data for ellipticals, and on the unique information available for the dark halo of our Galaxy.
In the Milky Way, the globular clusters are all very old, and we are accustomed to think of them as the oldest objects in the Galaxy. The clusters cover a wide range of chemical abundance, from near solar down to about [Fe/H] ⋍ −2.3. However there are field stars with abundances significantly lower than −2.3 (eg Bond, 1980); this implies that the clusters formed during the active phase of chemical enrichment, with cluster formation beginning at a time when the enrichment processes were already well under way.
First I will describe briefly some older work on chemical gradients in globular clusters. Then I will discuss some more recent data on the chemical and kinematical properties of 47 Tuc and Omega Cen, that leave us in little doubt about the reality of such chemical gradients.
Observations made at Las Campanas Observatory and at the Anglo-Australian Observatory have been used to determine line-of-sight velocities with an average accuracy of 3 kms−1 for 135 member stars in the globular cluster 47 Tucanae. The velocities were derived from cross-correlation techniques applied to 30 A/mm spectra obtained with digital sky-subtracting detectors. The spectra themselves have been used to analyze the cyanogen anomalies on the red giant branch in this cluster (Norris et al., 1984). When combined with the velocities published by the CORAVEL group (Mayor et al., 1983), these observations yield velocities for 212 stars with projected distances from the cluster center ranging from 3 to 68 core radii. After radial binning and analysis these observations yield the following results:
(i) The inner parts of the cluster show appreciable differential rotation with a maximum projected rotation velocity of approximately 6 kms−1 in the region 6–18 core radii. However, at larger radii the rotation declines rapidly and is essentially zero for radii greater than 30 core radii. This result is illustrated in Figure 1. To within the errors of the determinations, the position angle of the maximum rotation and that of the major axis of the stellar density distribution coincide.
(ii) In contrast to M3 (Gunn and Griffin 1979), “thermal equilibrium” multimass models (c.f. Da Costa and Freeman 1976) can ONLY reproduce the observed velocity dispersion values by including a substantial amount of “dark matter”; i.e. unlike M3, there is “missing mass” in 47 Tuc. In order to retain a fit to the surface brightness profile of the cluster, this “dark mass” (which provides perhaps 30 to 40 percent of the total cluster mass) cannot have a distribution much different from that of the cluster giants if it is in the form of stars and “thermal equilibrium” is maintained. In this case the obvious candidates for the dark matter are the white dwarf remnants of the stars more massive than the current turnoff mass, though many more such remnants are required than the number expected from extrapolating the present mass function. The difference between M3 and 47 Tuc in this case then implies that the 47 Tuc initial mass function had many more massive stars than did that for M3. The work of Freeman (1977), who demonstrated large IMF variations in the 8 − 1.5 solar mass range in young Magellanic Cloud clusters, provides observational support for this interpretation.
Why are the kinematics and dynamics of the Magellanic Clouds worth studying ? Some of the reasons are:
1.The Clouds are the closest examples of Magellanic systems. These asymmetric systems give some interesting dynamical problems. Because the Clouds are so close, a unique amount of information can be obtained on the kinematics of objects of all ages. This should be very helpful for understanding the dynamics.
2.The Clouds and the Galaxy are interacting. This produces complex kinematics of the gas in and between the Clouds, and also the Magellanic Stream. Again, very detailed information can be derived. We would like to know enough about the gas dynamics of interacting galaxies, to be able to explain the kinematics produced by this interaction.
3.The interaction will affect the star formation and chemical evolution in the Clouds. As new results are obtained on the star formation history and the chemical evolution, it is important to follow in parallel the dynamical history of the system, to see if the dynamics, star formation and chemical evolution can be tied together.