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This article aimed to address the feasibility of mentalization-based treatment (MBT) for patients with personality disorder in a non-specialist setting. The development and implementation of an MBT Programme is described.
A multidisciplinary Consult Group met to plan the implementation of the programme. Participants attended a psychoeducation group (MBT Introductory Group), then weekly individual and group therapy. Fourteen participants started the full programme with eight completing at least 9 months, complete data are available for five participants who completed 27 months (first cohort) and 21 months (second cohort). Data include quantitative measures and qualitative questionnaires/interviews. All had a diagnosis of personality dysfunction with co-morbid disorder including anxiety/depressive disorder, post-traumatic stress disorder and eating disorder.
Data on five participants revealed reductions in global level of distress, improvements in psychological well-being, less interpersonal difficulties and better work and social functioning. Qualitative data from feedback questionnaires (n = 18) and in-depth interview (n = 2) are discussed under the themes of mentalizing, treatment feedback/outcomes and group factors. Therapist reflections on the process identify the challenges involved in implementing a specialist psychotherapy programme within a general service and learning points from this are discussed.
MBT is an acceptable treatment for patients with personality dysfunction. Prior to the implementation of a programme, factors at the therapist, team and organizational level, as well as the wider context, need to be examined. This is to ensure that conditions are in place for proper adherence to the model to achieve the positive outcomes demonstrated in the RCT studies.
In May 2016, the National Academies of Sciences, Engineering, and Medicine (NASEM) released the report “Genetically Engineered Crops: Experiences and Prospects,” summarizing scientific consensus on genetically engineered crops and their implications. NASEM reports aim to give the public and policymakers information on socially relevant science issues. Their impact, however, is not well understood. This analysis combines national pre- and post-report survey data with a large-scale content analysis of Twitter discussion to examine the report’s effect on public perceptions of genetically modified organisms (GMOs). We find that the report’s release corresponded with reduced negativity in Twitter discourse and increased ambivalence in public risk and benefit perceptions of GMOs, mirroring the NASEM report’s conclusions. Surprisingly, this change was most likely for individuals least trusting of scientific studies or university scientists. Our findings indicate that NASEM consensus reports can help shape public discourse, even in, or perhaps because of, the complex information landscape of traditional and social media.
High definition video from a towed camera system was used to describe the deep-sea benthic habitats within an elongate depression located at the western margin of Rockall Bank in the Hatton–Rockall Basin. At depths greater than 1190 m, an extensive area (10 km long by 1.5 km wide) of what appeared to be reduced sediments, bacterial mats and flocculent matter indicated possible cold-seep habitat. Plumes of sediment-rich fluid were observed alongside raised elongate features that gave topographic relief to the otherwise flat seafloor. In the deepest section of the depression (1215 m) dense flocculent matter was observed suspended in the water column, in places obscuring the seabed. Away from the bacterial mats, the habitat changed rapidly to sediments dominated by tube-dwelling polychaete worms and then to deep-sea sedimentary habitats more typical for the water depth (sponges and burrowing megafauna in areas of gentle slopes, and coral gardens on steeper slopes).
The shear frame allows testing of thin weak snowpack layers that are often critical for slab avalanche release. A shear metal frame with an area of 0.01–0.05 m2 is used to grip the snow a few mm above a buried weak snowpack layer. Using a force gauge, the frame is pulled until a fracture occurs in the weak layer within 1 s. The strength is calculated from the maximum force divided by the area of the frame. Finite-element studies show that the shear stress in the weak layer is concentrated below the cross-members that subdivide the frame and where the weak layer is notched at the front and back of the frame. Placing the bottom of the frame in the weak layer increases the stress concentrations, and results in significantly lower strength measurements than placing the bottom of the frame a few mm above the weak layer. Based on over 800 sets of 7–12 tests in western Canada, coefficients of variation average 14% and 18% from level study plots and avalanche start zones, respectively. Consequently,sets of 12 tests typically yield a precision of the mean of 10% with 95% confidence, which is sufficient for monitoring of strength change of weak layers over time in study plots. With consistent technique, there is no significant difference in mean strength measurements obtained by different experienced shear frame operators using the same approximate loading rate and technique for placing the frame. Although fracture surfaces are usually planar, only one of eleven shapes of non-planar fracture surfaces showed significantly different strength compared to planar fracture surfaces. For weak layers thick enough for density measurements, the shear strength is plotted against density and grain form. From these data, empirical equations are determined to estimate the shear strength of weak snowpack layers.
The climatic snow line is a little above the highest peaks in this region (Mir Samir, 5 809 m, lat. 35° 35′ N., long. 70° 10′ E.) but steep north-facing slopes provide a topographie reason for small glaciers persisting, with a snow line a little below 4 900 in (16 000 ft). Snow accumulation at this height averages 1 300 kg m−2, most of this falling in late winter and spring. Gross ablation reaches 40 kg m−2 d−1. Net ablation (July–August), measured as stream discharge, averages 3 600 m3 d−1 = 9 kg m−2 d−1. Slow recession is the average condition. Halt stages at 4 800, 4 600 and 4 000 m are interpreted from the topography. Dating of moraines by lichen distribution indicates for the highest of these a minimum age of 400 years.
The vertical flux of heat and of water vapour were calculated through an air layer 30–100 cm over a melting firn surface for 24 h. The source of heat available at the surface expressed as a percentage of the total was: net radiation 87, condensation 5, forced convection 1, conduction through snow 6 and unexplained 1. The heat sink was: long-wave radiation 4, evaporation 6, forced convection 6, conduction into snow 2 and melting 82%.
The Swiss rutschblock test provides practical information about the stability of snow slabs. However, its use by avalanche workers and ski guides is limited by the time required to perform the test and recommended minimum slope inclination (30°). The present study shows how time requirements can be reduced by cutting rutschblocks with cords or specialized saws — faster techniques that do not appear to affect the results. Comparing the rutschblock results with a stability index developed in Switzerland shows that the recommended minimum slope inclination can be reduced to 20°, provided a second person is present to observe the small block displacements associated with slope inclinations below 30°. Sets of rutschblocks on slopes that vary in inclination by 8° or more are used to determine the effect of slope inclination on rutschblock scores. Also, the frequency distributions of six large sets of repeated tests are used to estimate the precision of one or two tests on a uniform slope.
During the 2009 influenza A (H1N1) pandemic, many pregnant women experienced severe illness and some gave birth while ill with suspected or confirmed pandemic (H1N1) 2009 influenza. Because of concerns about possible transmission of this novel virus to immunologically naïve newborns, and the absence of definitive studies regarding this risk, the Centers for Disease Control and Prevention (CDC) reviewed relevant literature to understand the potential burden of disease and routes of transmission affecting newborns. This report describes the issues considered during the 2009 H1N1 pandemic as CDC developed guidance to protect newborns in hospital settings. Also presented is a framework of protection efforts to prevent novel influenza infection in fetuses/newborns before birth and in hospital settings. Although developed specifically for the pandemic, the framework may be useful during future novel influenza outbreaks.
(Disaster Med Public Health Preparedness. 2012;6:97-103)
To determine whether drinking water contaminated with antimicrobial-resistant E. coli is associated with the carriage of resistant E. coli, selected households sending water samples to Ontario and Alberta laboratories in 2005–2006 were asked to participate in a cross-sectional study. Household members aged ⩾12 years were asked to complete a questionnaire and to submit a rectal swab. In 878 individuals, 41% carried a resistant strain of E. coli and 28% carried a multidrug-resistant strain. The risk of carriage of resistant E. coli was 1·26 times higher for users of water contaminated with resistant E. coli. Other risk factors included international travel [prevalence ratio (PR) 1·33], having a child in nappies (PR 1·33), being male (PR 1·33), and frequent handling of raw red meats (PR 1·10). Protecting private water sources (e.g. by improving systems to test and treat them) may help slow the emergence of antimicrobial resistance in E. coli.
CoSi2 epitaxial layers with thickness ranging from 24 nm to 170 nm have been grown onto porous Si substrates by molecular beam epitaxy. The X-ray rocking curves and transmission electron microscopy (TEM) are used to examine the strain relaxation and interface quality. Backscattering with channeling is used to characterize the crystallinity of the epilayers. The results show that it is necessary to grow a thin buffer Si layer in order to improve the interfacial sharpness and crystallinity of the epilayers; near perfect crystallinity is then obtained as the thickness of the CoSi2 films exceed 50 nm. TEM results reveal that both CoSi2/Si and CoSi2/porous-Si interfaces are flat and layer thickness is uniform. It is found by TEM that the dislocation density of CoSi2 grown on porous Si is much lower than that on single-crystal Si. For thin CoSi2 grown on porous Si, the TEM and strain measurement results imply that part of the film is pseudomorphic where no dislocations are observed. Average strains of CoSi2 films grown on porous Si substrates with thicknesses greater than 30 nm show a lower strains comparing to that on crystalline Si. This suggests that by using porous Si as substrates the stress energy in the epilayer can be accommodated by the Si buffer layer that bridged over the trenches of porous Si.
Damaged layers, buried underneath the surface of type IIa diamond slabs by 2.8 MeV C+ ion implantation have been subjected to irradiation with 14 ns pulses from a focused Nd-Glass laser. At high powers, ablation of the implanted surface was observed. However, the correct choice of laser power and wavelength results in annealing of the implanted layer without any disruption to the surface morphology. Annealing was confirmed by optical measurements showing a decrease in the GR-1 absorption band, and by channelled Rutherford Backscattering Spectroscopy on the small 10μm diameter laser irradiated spots. The results suggest that an undamaged diamond cap can be utilized to promote damage annealing of diamond by pulsed laser beams, for which the annealing in other materials has been shown to proceed via the melt. The surface cap is believed to aid in the production of extremely high internal pressures in the damaged layer during the laser pulse which prevents graphitization and promotes diamond regrowth.
GaAs layers have been grown on porous silicon (PS) substrates by molecular beam epitaxyNo surface morphology deterioration was observed onGaAs-on-PS layers in spite of the roughness of PS. A 10% Rutherford backscattering spectroscopy (RBS) channeling minimum yield for GaAs-on-PS layers as compared to 16% for GaAs-on-Si layers grown under the same condition indicates a possible improvement of crystallinity when GaAs is grown on PS. Transmission electron microscopy (TEM) reveals that the dominant defects in the GaAs-on-PS layers are microtwins and stacking faults, which originate from the GaAs/PS interface. GaAs is found to penetrate into the PS layers.
We have studied the formation of buried oxide in MeV oxygen implanted Si. A continuous oxide layer is formed in the samples implanted with 2x1018/cm2 oxygen and annealed at 1300° C. The microstructures are studied by cross-sectional transmission electron microscopy and high resolution electron microscopy. Chemical information was obtained by electron energy loss spectroscopy. The effects of implantation temperature are studied. Implantation at a low substrate temperature leads to a well-defined buried SiO2 layer, inhibits the formation of oxide precipitates in the silicon, and reduces silicon inclusions in the SiO2.
A comprehensive study of MeV-15N-ion-implanted InP by a variety of analytical techniques has revealed the physical processes involved in MeV ion implantation into III-V compound semiconductors as well as the influence of post-implantation annealing. It provides a coherent picture of implant distribution, structural transition, crystalline damage, and lattice strain in InP crystals induced by ion implantation and thermal annealing. The experimental results from the different measurements are summarized in this report. Mechanisms of amorphization by implantation and recrystallization through annealing in MeV-ion-implanted InP are proposed and discussed in light of the results obtained.
The effect of large dose boron implantation in single crystal CdTe has been investigated by Rutherford Backscattering Spectrometry with channeling (RBS), double crystal x-ray diffraction (DCD) and photoreflectance spectroscopy (PR). Comparisons are made with the results of identical B implantations of Si and GaAs crystals. Multiple energy implantations were performed at room temperature and liquid nitrogen temperature with total doses up to 1.5×1016 B+ ions/cm2. The implanted B distribution was measured with neutron depth profiling (NDP) and found to agree well with Monte-Carlo ion range calculations. The RBS results showed that the CdTe crystals had not been rendered completely amorphous even for the highest dose implantation, unlike GaAs and Si. Furthermore, the DCD results showed little implantation induced structure in the rocking curves from the implanted CdTe crystals, in contrast to GaAs. The consequences of annealing at 500°C in an attempt to regrow the crystal structure are also discussed.
Annealing behavior of point defects near room temperature is studied by measuring the strain relaxation of Si+ implanted GaAs. Polished semi-insulating GaAs wafers were implanted with 300keV Si+ at liquid nitrogen ( LN2 ) and room temperature (RT ). The strain profile was obtained by the X-ray Double Crystal Diffraction ( DCD) technique and kinematical fitting. The maximum strain of the samples stored at RT and elevated temperature 100°C in air, decreases with time, which indicates the reduction of point defects. Relaxation is exponential in time. At least two time constants of 0.24hrs and 24hrs are needed to fit the data, suggesting that two different processes are responsible for annealing defects. Time constants are obtained for different doses at RT and LN2 implantation temperature, and found to be insensitive to both these quantities. The activation energy for defect migration is estimated using simple diffusion model.
The relationship between growth rate of CrSi2 and dose rate during Xe ion irradiation at 500K is investigated. Dose raies difffering by up to a factor of 40 have been utilized to study the relationship. For a fixed total dose, a lower dose rate results in a thicker silicide layer compound to a higher dose rate. The results are explained from radiation-enhanced diffusion theory.
Monocrystals of magnesium oxide and sapphire have been subjected to ion implantation with 86 keV Si− ions to a dose of 5×1016 cm−2 and with 3 MeV H+ ions with a dose of 4.8×1017 cm−2 prior to thermal stress testing in a pulsed plasma. Fracture and deformation characteristics of the surface layer were measured in ion implanted and unimplanted samples using optical and scanning electron microscopy. Ion implantation is shown to modify the near-surface structure of samples by introducing damage, which makes crack nucleation easier under the applied stress. The effect of ion dose on the thermal stress resistance is investigated and the critical doses which produce a noticeable change in the stress resistance is determined for sapphire crystals implanted with 86 keV Si−. In comparison with 86 keV Si− ions the high energy implantation of sapphire and magnesium oxide crystals with 3 MeV H+ ions results in the formation of large-scale defects, which produce a low density crack system and cause a considerable reduction in the resistance to damage. Fracture mechanics principles are applied to evaluate the size of the implantation-induced microcracks which are shown to be comparable with the ion range and the damage range in the crystals tested. Possible mechanisms of crack nucleation for a low and high energy ion implantation are discussed.
Successful, effective, mutually beneficial military participation in what we would call civilian law enforcement is not unknown in history. Ancient Rome and the contemporary French Gendarmerie – who have an excellent working relationship with the rural population of France – might be included on a list of good examples. Unfortunately, the list of oppressive, abusive, even genocidal examples seems infinitely longer, and this list is surely a source of our national apprehension about using our military forces for standard police work.
Our founding fathers were, of course, sensitive to this issue and sought to minimize the possibility that the American public would suffer oppressive use of the military by unethical government leaders. Indeed, although military resources have been utilized countless times in response to domestic disasters and catastrophes, we tend to focus our collective memory on the tragic results of hostile encounters like the New York draft riots, Kent State, or the Texas border country, where military force has been used in response to civilian behavior with tragic results. We simply do not want our military involved in law enforcement in civilian environments, or controlling civilian behavior of any type, especially when the use of force might be deemed necessary. It might be worth noting that the bright line that separates the military and civil sectors is less clearly drawn in most other advanced Western societies, largely because the insulation against invaders provided by two vast oceans is a luxury that European nation-states do not share.