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Despite its established efficacy, access to internet-delivered CBT (iCBT) remains limited in a number of countries. Translating existing programs and using a minimally monitored model of delivery may facilitate its dissemination across countries.
This randomized control trial aims to evaluate the efficacy of an iCBT transdiagnostic program translated from English to French and offered in Canada using a minimally monitored delivery model for the treatment of anxiety and depression.
Sixty-three French speakers recruited in Canada were randomized to iCBT or a waiting-list. A French translation of an established program, the Wellbeing Course, was offered over 8 weeks using a minimally monitored delivery model. Primary outcome measures were the Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9), which were obtained pre-treatment, post-treatment and at 3-month follow-up.
Mixed-effects models revealed that participants in the treatment group had significantly lower PHQ-9 and GAD-7 scores post-treatment than controls with small between-groups effect sizes (d = 0.34 and 0.37, respectively). Within-group effect sizes on primary outcome measures were larger in the treatment than control group. Clinical recovery rates on the PHQ-9 and GAD-7 were significantly higher among the treatment group (40 and 56%, respectively) than the controls (13 and 16%, respectively).
The provision of a translated iCBT program using a minimally monitored delivery model may improve patients’ access to treatment of anxiety and depression across countries. This may be an optimal first step in improving access to iCBT before sufficient resources can be secured to implement a wider range of iCBT services.
As more debates in American politics become constitutional questions, effective citizens must engage in constitutional interpretation. While most Americans venerate the Constitution as a part of a national, civil religion, levels of constitutional knowledge are also very low. In this paper, we analyze how ordinary Americans approach the task of constitutional interpretation. An analysis of two cross-sectional surveys indicates constitutional hermeneutics are a product of political factors, religious affiliation, and biblical interpretive preferences. We also present the results of a survey experiment where the manipulation of a clergy's interpretation of a biblical passage affects how respondents interpret both scripture and the Constitution, providing a potential causal mechanism for learning how to engage in hermeneutics.
The adoption of chemical fallow rotations in Pacific Northwest dryland winter wheat production has caused a weed species composition shift in which scouringrush has established in production fields. Thus, there has been interest in identifying herbicides that effectively control scouringrush in winter wheat–chemical fallow cropping systems. Field experiments were established in growers’ fields near Reardan, WA, in 2014, and The Dalles, OR, in 2015. Ten herbicide treatments were applied to mowed and nonmowed plots during chemical fallow rotations. Scouringrush stem densities were quantified the following spring and after wheat harvest at both locations. Chlorsulfuron plus MCPA-ester resulted in nearly 100% control of scouringrush through wheat harvest. Before herbicide application, mowing had no effect on herbicide efficacy. We conclude chlorsulfuron plus MCPA-ester is a commercially acceptable treatment for smooth and intermediate scouringrush control in winter wheat–chemical fallow cropping systems; however, the lack of a positive yield response when scouringrushes were controlled should factor into management decisions.
Campylobacter is the leading cause of foodborne bacterial gastroenteritis in humans worldwide, often associated with the consumption of undercooked poultry. In Jordan, the majority of broiler chicken production occurs in semi-commercial farms, where poor housing conditions and low bio-security are likely to promote campylobacter colonisation. While several studies provided estimates of the key parameters describing the within-flock transmission dynamics of campylobacter in typical high-income countries settings, these data are not available for Jordan and Middle-East in general. A Bayesian model framework was applied to a longitudinal dataset on Campylobacter jejuni infection in a Jordan flock to quantify the transmission rate of C. jejuni in broilers within the farm, the day when the flock first became infected, and the within-flock prevalence (WFP) at clearance. Infection with C. jejuni is most likely to have occurred during the first 8 days of the production cycle, followed by a transmission rate value of 0.13 new infections caused by one infected bird/day (95% CI 0.11–0.17), and a WFP at clearance of 34% (95% CI 0.24–0.47). Our results differ from published studies conducted in intensive poultry production systems in high-income countries but are well aligned with the expectations obtained by means of structured questionnaires submitted to academics with expertise on campylobacter in Jordan. This study provides for the first time the most likely estimates and credible intervals of key epidemiological parameters driving the dynamics of C. jejuni infection in broiler production systems commonly found in Jordan and the Middle-East and could be used to inform Quantitative Microbial Risk Assessment models aimed to assess the risk of human exposure/infection to campylobacter through consumption of poultry meat.
This paper updates Living with Mortality published in 2006. It describes how the longevity risk transfer market has developed over the intervening period, and, in particular, how insurance-based solutions – buy-outs, buy-ins and longevity insurance – have triumphed over capital markets solutions that were expected to dominate at the time. Some capital markets solutions – longevity-spread bonds, longevity swaps, q-forwards and tail-risk protection – have come to market, but the volume of business has been disappointingly low. The reason for this is that when market participants compare the index-based solutions of the capital markets with the customised solutions of insurance companies in terms of basis risk, credit risk, regulatory capital, collateral and liquidity, the former perform on balance less favourably despite a lower potential cost. We discuss the importance of stochastic mortality models for forecasting future longevity and examine some applications of these models, e.g. determining the longevity risk premium and estimating regulatory capital relief. The longevity risk transfer market is now beginning to recognise that there is insufficient capacity in the insurance and reinsurance industries to deal fully with demand and new solutions for attracting capital markets investors are now being examined – such as longevity-linked securities and reinsurance sidecars.
Background: Although internet-delivered cognitive behaviour therapy (ICBT) yields large clinical outcomes when accompanied by therapeutic support, a portion of clients do not benefit from treatment. In ICBT, clients review treatment materials online typically on a weekly basis. A key component of therapist-assistance involves answering questions as clients review and work on assignments related to the treatment materials. Aims: The goal of this study was to enhance understanding of the nature of client questions posed during ICBT and examine potential associations between the number of questions asked and treatment outcomes in order to provide insight into how to improve ICBT for future users. Method: Content analysis was used to qualitatively analyse and identify questions that 80 clients asked their designated therapist over the course of an 8-week ICBT programme for anxiety and depression. Results: On average, clients sent six emails during the course of treatment, of which less than two questions were asked. Of the 137 questions posed by clients, 46.72% reflected questions designed to enhance understanding and apply the material and techniques reviewed in the programme. Additional questions were categorized as clarifying the therapeutic process (22.62%), addressing technical challenges (18.25%), and seeking assistance with problems outside the scope of ICBT (12.41%). Number of client questions asked was not significantly correlated with the number of lessons completed, symptom change, or perceptions of therapeutic alliance. Conclusions: Findings can inform future practitioners who deliver ICBT of what to expect with this treatment approach and also assist in the development of future ICBT programmes.
Field experiments were performed in 2016 and 2017 in Missouri to determine whether interactions exist between PRE herbicides and seed treatments in soybean. The experiments consisted of a randomized complete block design with factorial arrangements of varieties, seed treatments, and herbicides. We selected two genetically similar varieties of soybean, one with known tolerance to PPO-inhibiting herbicides and one with known sensitivity. Each variety of seed received three separate seed treatment mixtures (STMs): (1) STM1, imidacloprid plus prothioconazol+penflufen+metalaxyl plus metalaxyl plus Bacillus subtilis+B. pumilis, (2) STM2, Pasteuria nishizawae plus thiamethoxam plus prothioconazol+penflufen+metalaxyl plus metalaxyl plus B. subtilis+B. pumilis, and (3) STM3, fluopyram plus imidacloprid plus prothioconazol+penflufen+metalaxyl plus metalaxyl plus B. subtilis+B. pumilis. Chlorimuron-ethyl+flumioxazin+pyroxasulfone, chlorimuron-ethyl+flumioxazin+metribuzin, and chlorimuron-ethyl+sulfentrazone were applied PRE to each variety and seed treatment combination at 1× and 2× the labeled use rate. Chlorimuron-ethyl+sulfentrazone treatment at the 2× rate resulted in greater injury of 8% and 14% to the sensitive variety than the tolerant in 2016 and 2017, respectively; this was the highest injury observed from any herbicide treatment in either year. In 2017, chlorimuron-ethyl+sulfentrazone resulted in the greatest height reductions in both varieties, but this reduction was more evident in the sensitive (19%) than in the tolerant (6%) variety. Overall, yield differences between the two varieties were not consistent between years, and for both varieties, the sulfentrazone-containing treatments resulted in the highest yield losses. The results of this research indicate that there is a larger interaction between herbicides and varieties than there is between herbicides and seed treatments, or seed treatments and varieties.
Translating existing internet-based cognitive-behavioural therapy (iCBT), along with the use of transdiagnostic and self-guided formats, may prove to be a cost-effective option of disseminating iCBT. Only recently have encouraging findings been reported for a self-guided delivery. This study assessed the feasibility of a French and self-guided version of an existing English iCBT course, called the Wellbeing Course, for the treatment of anxiety and depression. Existing ICBT programs have not yet been delivered in French, although this language is spoken worldwide. Thirty-one participants were included in a single group pre-post open trial with a 3-month follow-up. Feasibility outcomes were attrition, treatment adherence, acceptability, and preliminary efficacy. Primary outcome measures were the Patient Health Questionnaire 9-item (PHQ-9) and the Generalised Anxiety Disorder 7-item (GAD-7). Nearly 75% of the participants completed the program. Over 80% of the participants provided posttreatment and follow-up data. All study completers reported that they would recommend the Wellbeing Course to a friend having similar problems. Significant reductions in symptoms of anxiety and depression were found following treatment, consistent with earlier studies. These preliminary findings support the use of the assessed strategies to facilitate the cross-cultural dissemination of iCBT for a more universal access to quality psychological care.
Research was conducted from 2015 to 2017 to investigate the potential for 2,4-D and multiple herbicide resistance in a waterhemp [Amaranthus tuberculatus (Moq.) J. D. Sauer] population from Missouri (designated MO-Ren). In the field, visual control of the MO-Ren population with 0.56 to 4.48 kg 2,4-D ha−1 ranged from 26% to 77% in 2015 and from 15% to 55% in 2016. The MO-Ren population was highly resistant to chlorimuron, with visual control never exceeding 7% either year. Estimates of the 2,4-D dose required to provide 50% visual control (I50) of the MO-Ren population were 1.44 kg ha−1 compared with only 0.47 kg 2,4-D ha−1 for the susceptible population. Based on comparisons to a susceptible population in dose–response experiments, the MO-Ren population was approximately 3-fold resistant to 2,4-D, and 7-, 7-, 22-, and 14-fold resistant to atrazine, fomesafen, glyphosate, and mesotrione, respectively. Dicamba and glufosinate were the only two herbicides that provided effective control of the MO-Ren population in these experiments. Examinations of multiple herbicide resistance at the individual plant level revealed that 16% of the plants of the MO-Ren population contained genes stacked for six-way herbicide resistance, and only 1% of plants were classified as resistant to a single herbicide (glyphosate). Results from these experiments confirm that the MO-Ren A. tuberculatus population is resistant to 2,4-D, atrazine, chlorimuron, fomesafen, glyphosate, and mesotrione, making this population the third 2,4-D–resistant A. tuberculatus population identified in the United States, and the first population resistant to six different herbicidal modes of action.
The Taipan galaxy survey (hereafter simply ‘Taipan’) is a multi-object spectroscopic survey starting in 2017 that will cover 2π steradians over the southern sky (δ ≲ 10°, |b| ≳ 10°), and obtain optical spectra for about two million galaxies out to z < 0.4. Taipan will use the newly refurbished 1.2-m UK Schmidt Telescope at Siding Spring Observatory with the new TAIPAN instrument, which includes an innovative ‘Starbugs’ positioning system capable of rapidly and simultaneously deploying up to 150 spectroscopic fibres (and up to 300 with a proposed upgrade) over the 6° diameter focal plane, and a purpose-built spectrograph operating in the range from 370 to 870 nm with resolving power R ≳ 2000. The main scientific goals of Taipan are (i) to measure the distance scale of the Universe (primarily governed by the local expansion rate, H0) to 1% precision, and the growth rate of structure to 5%; (ii) to make the most extensive map yet constructed of the total mass distribution and motions in the local Universe, using peculiar velocities based on improved Fundamental Plane distances, which will enable sensitive tests of gravitational physics; and (iii) to deliver a legacy sample of low-redshift galaxies as a unique laboratory for studying galaxy evolution as a function of dark matter halo and stellar mass and environment. The final survey, which will be completed within 5 yrs, will consist of a complete magnitude-limited sample (i ⩽ 17) of about 1.2 × 106 galaxies supplemented by an extension to higher redshifts and fainter magnitudes (i ⩽ 18.1) of a luminous red galaxy sample of about 0.8 × 106 galaxies. Observations and data processing will be carried out remotely and in a fully automated way, using a purpose-built automated ‘virtual observer’ software and an automated data reduction pipeline. The Taipan survey is deliberately designed to maximise its legacy value by complementing and enhancing current and planned surveys of the southern sky at wavelengths from the optical to the radio; it will become the primary redshift and optical spectroscopic reference catalogue for the local extragalactic Universe in the southern sky for the coming decade.
Clathrate Hydrates can be formed under high vacuum conditions by annealing vapor-deposited amorphous ices of the appropriate composition. When astrophysically significant H2O:CH3OH ices are deposited and annealed, Type II Clathrate Hydrates are formed which can hold up to 6 mole % large guest molecules such as methanol and 12 mole % small guest molecules such as CO2 and CO. The solid state transformation of amorphous mixed molecular ice into crystalline clathrate hydrate and its sublimation at higher temperatures may serve to explain heretofore anomalous mechanical and gas release properties observed in cometary ices and laboratory ice analog experiments.
Parasites of the genera Plasmodium and Haemoproteus (Apicomplexa: Haemosporida) are a diverse group of pathogens that infect birds nearly worldwide. Despite their ubiquity, the ecological and evolutionary factors that shape the diversity and distribution of these protozoan parasites among avian communities and geographic regions are poorly understood. Based on a survey throughout the Neotropics of the haemosporidian parasites infecting manakins (Pipridae), a family of Passerine birds endemic to this region, we asked whether host relatedness, ecological similarity and geographic proximity structure parasite turnover between manakin species and local manakin assemblages. We used molecular methods to screen 1343 individuals of 30 manakin species for the presence of parasites. We found no significant correlations between manakin parasite lineage turnover and both manakin species turnover and geographic distance. Climate differences, species turnover in the larger bird community and parasite lineage turnover in non-manakin hosts did not correlate with manakin parasite lineage turnover. We also found no evidence that manakin parasite lineage turnover among host species correlates with range overlap and genetic divergence among hosts. Our analyses indicate that host switching (turnover among host species) and dispersal (turnover among locations) of haemosporidian parasites in manakins are not constrained at this scale.
A derivative of the Danish tipping-lower intermediate-depth ice-coring drill system has been developed for use in remote areas. The system as described is capable of drilling to depths of 250 m, although the drill has been proven to 350 m. The drill system is designed to be transported by hand and consumes 700 W maximum power from a 24 V Ac. battery bank charged by solar panels or a small generator. A field test in the St Elias Mountains, Yukon, produced good-quality core to 161.6 m depth; drilling at 6500 m a.s.l. on Far East Rongbuk Glacier, Mount Everest, produced good core to 42 m depth.
Streptococcus pneumoniae (Spn) is a leading cause of community-acquired pneumonia (CAP), yet existing diagnostic tools remain inadequate. We aimed to evaluate laboratory and radiological methods for detecting pneumococcal aetiology in CAP patients and to estimate Spn prevalence in this group. All-aged patients hospitalized with clinically defined CAP in northern Togo were enrolled during 2010–2013. Latent class analysis pooled results of semi-automated blood culture (SABC), whole blood lytA real-time polymerase chain reaction (rt-PCR), serum C-reactive protein (CRP), and chest radiography (CXR) and categorized patients as likely pneumococcal or non-pneumococcal CAP. We enrolled 1684 patients; 1501 had results for all tests. CXR, SABC, lytA rt-PCR and CRP >71·2 mg/l had sensitivities of 94% [95% confidence interval (CI) 87–100], 13% (95% CI 10–16), 17% (95% CI 14–21) and 78% (95% CI 75–80), and specificities of 88% (95% CI 84–93), 100% (95% CI 99–100), 97% (95% CI 96–99) and 77% (95% CI 75–79), respectively. Pneumococcal attributable proportion was 34% (95% CI 32–37), increasing with age and in men. We estimated that Spn caused one third of CAP. Whole blood lytA rt-PCR was more sensitive than SABC; both had low sensitivity and high specificity. Conversely CXR was highly sensitive and reasonably specific; it could be a useful tool for epidemiological studies aiming to define Spn pneumonia incidence across all ages.
The archaeological evidence for parasites in the Roman era is presented in order to demonstrate the species present at that time, and highlight the health consequences for people living under Roman rule. Despite their large multi-seat public latrines with washing facilities, sewer systems, sanitation legislation, fountains and piped drinking water from aqueducts, we see the widespread presence of whipworm (Trichuris trichiura), roundworm (Ascaris lumbricoides) and Entamoeba histolytica that causes dysentery. This would suggest that the public sanitation measures were insufficient to protect the population from parasites spread by fecal contamination. Ectoparasites such as fleas, head lice, body lice, pubic lice and bed bugs were also present, and delousing combs have been found. The evidence fails to demonstrate that the Roman culture of regular bathing in the public baths reduced the prevalence of these parasites. Fish tapeworm was noted to be widely present, and was more common than in Bronze and Iron Age Europe. It is possible that the Roman enthusiasm for fermented, uncooked fish sauce (garum) may have facilitated the spread of this helminth. Roman medical practitioners such as Galen were aware of intestinal worms, explaining their existence and planning treatment using the humoural theory of the period.
Many of the effects of mass loss on OB stars have now been explored. Mass loss will cause a star to be overluminous for its mass (though less luminous than a star of its original mass) and, for moderate mass-loss rates, the luminosity decreases at the same rate as the mass contained in the convective core decreases causing the main sequence lifetime to remain unchanged (Chiosi and Nasi 1974, 1978, Deloore, DeGreve and Lamers 1977, Dearborn, Blake, Hainebach and Schramm 1978). Mass loss can also expose layers where 14N has been enhanced via the CNO tricyle (Dearborn and Eggleton 1977) and, in extreme cases, can produce a stripped helium core resembling a Wolf-Rayet Star (Hartwick 1967). While many of these phenomena (in particular the composition change) are more sensitive to the total mass removed than the formalism used to represent the mass loss, significant differences will result for the same average mass-loss rate depending on whether the mass was removed early (near the ZAMS), or late (near core hydrogen depletion). In addition, there appears to be a critical mass loss rate which depends on initial mass and separates those models which continue to evolve in a relatively normal (though subluminous) manner, and those models which evolve to a Wolf-Rayet configuration.