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Little is known about the experiences of people living alone with dementia in the community and their non-resident relatives and friends who support them. In this paper, we explore their respective attitudes and approaches to the future, particularly regarding the future care and living arrangements of those living with dementia. The study is based on a qualitative secondary analysis of interviews with 24 people living alone with early-stage dementia in North Wales, United Kingdom, and one of their relatives or friends who supported them. All but four of the dyads were interviewed twice over 12 months (a total of 88 interviews). In the analysis, it was observed that several people with dementia expressed the desire to continue living at home for ‘as long as possible’. A framework approach was used to investigate this theme in more depth, drawing on concepts from the existing studies of people living with dementia and across disciplines. Similarities and differences in the future outlook and temporal orientation of the participants were identified. The results support previous research suggesting that the future outlook of people living with early-stage dementia can be interpreted in part as a response to their situation and a way of coping with the threats that it is perceived to present, and not just an impaired view of time. Priorities for future research are highlighted in the discussion.
Thirteen major depressive patients not responding to a 4-week venlafaxine 300 mg treatment were eligible for a 4-week open trial of lithium addition. Two patients had to stop lithium for a possible moderate serotonin syndrome and five patients became responders, including one dramatic response and two semi-rapid responses.
We evaluated the efficacy of eszopiclone (ESZ) and concurrent escitalopram oxalate (EO) in patients with insomnia and co-morbid GAD.
Patients meeting DSM-IV-TR criteria for GAD and insomnia received 10 weeks of EO 10mg and co-therapy with ESZ 3mg or placebo (PBO) for 8 weeks. For the last 2 weeks, ESZ was replaced with single-blind PBO to evaluate discontinuation effects. Sleep, daytime functioning and anxiety measures were captured during the study.
ESZ+EO improved sleep and daytime functioning at each week and the double-blind period average (p<0.05). At Week 8, significantly more ESZ+EO patients had no clinically meaningful insomnia based on ISI</=7. Significant improvements with ESZ+EO (relative to PBO+EO) were observed in HAM-A total scores each week, and Weeks 4-10 excluding the insomnia item. ESZ+EO was significantly better at every timepoint on CGI-I (p<0.02); CGI-S was not different between treatments after Week 1. Median time to anxiolytic response was reduced with ESZ+EO based on HAM-A and CGI-I. HAM-A response and remission rates at Week 8 were higher with ESZ+EO, and HAM-D17 scores were improved at all timepoints (p<0.004). After eszopiclone discontinuation, there was no evidence of rebound insomnia, and no treatment differences in sleep or daytime function. Significant treatment differences in anxiety and mood were maintained after discontinuation.
In this study, ESZ+EO was well tolerated and associated with improved sleep and daytime function without evidence of tolerance. Improvements in anxiety and mood were observed with ESZ+EO.
Support for this study provided by Sepracor Inc., Marlborough, MA.
Neuroimaging studies of depression have demonstrated treatment-specific changes involving the limbic system and regulatory regions in the prefrontal cortex. While these studies have examined the effect of short-term, interpersonal or cognitive-behavioural psychotherapy, the effect of long-term, psychodynamic intervention has never been assessed. Here, we investigated recurrently depressed (DSM-IV) unmedicated outpatients (N=16) and control participants matched for sex, age, and education (N=17) before and after 15 months of psychodynamic psychotherapy. Participants were scanned at two time points, during which presentations of attachment-related scenes with neutral descriptions alternated with descriptions containing personal core sentences previously extracted from an attachment interview. Outcome measure was the interaction of the signal difference between personal and neutral presentations with group and time, and its association with symptom improvement during therapy. Signal associated with processing personalized attachment material varied in patients from baseline to endpoint, but not in healthy controls. Patients showed a higher activation in the left anterior hippocampus/amygdala, subgenual cingulate, and medial prefrontal cortex before treatment and a reduction in these areas after 15 months. This reduction was associated with improvement in depressiveness specifically, and in the medial prefrontal cortex with symptom improvement more generally. This is the first study documenting neurobiological changes in circuits implicated in emotional reactivity and control after long-term psychodynamic psychotherapy.
Metal chalcogenides have attracted great attention because of their broad applications. It has been well acknowledged that microstructure can alter the intrinsic properties and performance of metal chalcogenides. The structure–property–performance relationships can be investigated at atomic scale with scanning transmission and transmission electron microscopy (STEM and TEM). Nevertheless, careful specimen preparation is paramount for accurate analyses and interpretations. In this work, we compare the effects of a variety of well-established TEM specimen preparation methods on the observed microstructure of an ingot stoichiometric lead telluride (PbTe). Most importantly, from aberration corrected STEM and first principles calculations, we discovered that argon (Ar) ion milling can lead to surface irradiation damage in the form of Pb vacancy clusters and self-interstitial atom (SIA) clusters. The SIA clusters appear as orthogonal nanoscale features when characterized along the <001> crystal orientation of the rock salt structured PbTe. This obfuscates the interpretation of the intrinsic microstructure of metal chalcogenides, especially lead chalcogenides. We demonstrate that with sufficiently low energy (300 eV) Ar ion cleaning or appropriate high-temperature annealing, the surface damage layer can be properly cleaned and the orthogonal nanoscale features are significantly reduced. This reveals the materials’ intrinsic structure and can be used as the standard protocol for future TEM specimen preparation of lead-based chalcogenide materials.
The Best Practices in Social and Behavioral Research Course was developed to provide instruction on good clinical practice for social and behavioral trials. This study evaluated the new course.
Participants across 4 universities took the course (n=294) and were sent surveys following course completion and 2 months later. Outcomes included relevance, how engaging the course was, and working differently because of the course. Open-ended questions were posed to understand how work was impacted.
Participants rated the course as relevant and engaging (6.4 and 5.8/7 points) and reported working differently (4.7/7 points). Participants with less experience in social and behavioral trials were most likely to report working differently 2 months later.
The course was perceived as relevant and engaging. Participants described actions taken to improve rigor in implementing trials. Future studies with a larger sample and additional participating sites are recommended.
The two-temperature, 2D hydrodynamic code Hydro–ELectro–IOnization–2–Dimensional (HELIO2D), which takes into account self-consistently the laser energy absorption in a target, ionization, heating, and expansion of the created plasma is elaborated. The wide-range two-temperature equation of state is developed and used to model the metal target dynamics from room temperature to the conditions of weakly coupled plasma. The simulation results are compared and demonstrated a good agreement with experimental data on the Mg target being heated by laser pulses of the nanosecond high-energy laser for heavy ion experiments (NHELIX) at Gesellschaft fur Schwerionenforschung. The importance of using realistic models of matter properties is demonstrated.
At the heart of a flight simulator resides the mathematical representation of aircraft behaviour in response to control inputs, atmospheric disturbances and system inputs including failures and malfunctions. While this mathematical model can never be wholly accurate, its fidelity, in comparison with real world behaviour, underpins the usefulness of the flight simulator. The present paper examines the state of the art achieved in validating mathematical models for helicopter simulators, addressing the strengths and weaknesses of the present European standard for the qualification of helicopter flight simulators, JAR FSTD-H (previously JAR-STD-1H/2H/3H). Essential questions are examined, such as: What is the required model fidelity to guarantee a simulation is sufficiently representative to be fit for purpose? Are the tolerances set in the current standards fine enough that they lead to only minor changes in handling qualities? What is an acceptable tuning process for the simulation? What is the effect of modelling fidelity on the overall pilot control strategy? What is the relationship between the settings of the simulator cueing environment and the behaviour of the pilot? What is the industrial experience on qualification of flight simulators that might usefully inform developments? Many of these questions were addressed in Europe in a previous GARTEUR Action Group (AG) HC/AG-12 the results of which are documented in this paper. Solutions are proposed for improving the current JAR-FSTD standard with respect to validation of mathematical models.
This paper investigates prospects of utilizing a high-power laser-driven target-normal-sheath-acceleration proton beam for the experimental demonstration of the magnetic self-focusing phenomenon in charged particle beams. In the proposed concept, focusing is achieved by propagating a space-charge dominated ion beam through a stack of thin conducting and grounded foils separated by vacuum gaps. As the beam travels through the system, image charges build up at the foils and generate electric field that counteracts the beam's electrostatic self-field — a dominant force responsible for expansion of a high current beam. Once the electrostatic self-field is “neutralized” by the image charges, the beam currents magnetic self-field will do the focusing. The focal spot size and focal length depends on the choice of a number of foils and distance between foils. Considering the typical electrical current level of a target-normal-sheath-acceleration proton beam, we conclude that it is feasible to focus or collimate a beam within tens of millimeters distance, e.g., using 200–1000 Al foils, 0.5 µm thick each, with foil spacing ranging from 25 µm to 100 µm. These requirements are within technical capabilities of modern target fabrication, thus allowing the first possible demonstration of the pinch effect with heavy ion beams.
Due to its location and climate, Antarctica offers unique conditions
for long-period observations across a broad wavelength regime,
where important diagnostic lines for molecules and ions can be found,
that are essential to understand the chemical properties of the interstellar
medium. In addition to the natural benefits of the site, new
technologies, resulting from astrophotonics, may allow miniaturised instruments,
that are easier to winterise and advanced filters to further
reduce the background in the infrared.
The CRESST-II direct Dark Matter search is located in the Gran Sasso underground laboratories, Italy. CaWO4 crystals are used as scintillating targets for WIMP (weakly interacting massive particle) interactions. They are operated as cryogenic calorimeters in combination with a second cryogenic detector used to measure the scintillation light produced in the target crystal. For each particle interaction, the combination of phonon and light signals provides an event by event discrimination which allows to distinguish known particles (alphas, betas, gammas, neutrons) from the expected signal of WIMPs. A major upgrade of the setup comprises modifications of the shielding, installation of a muon-veto, and new read out electronics, as well as a new detector-support structure to accommodate up to 33 detector modules, i.e. 10 kg of target mass. The experiment was thereafter successfully commissioned in 2007. Data obtained during this commissioning phase from 2 detector modules are presented here. Combining the data collected with these two detector modules with data from one single module obtained during the CRESST-I phase, the experiment could already place a limit of ~6 × 10-7 pb for the spin independent WIMP-nucleon scattering cross section at a WIMP mass of ~60 GeV/c2.
EURECA (European Underground Rare Event Calorimeter Array) is an
astro-particle physics facility aiming to directly detect galactic dark
matter. The Laboratoire Souterrain de Modane has been selected as host
laboratory. The EURECA collaboration unites CRESST, EDELWEISS and the
Spanish-French experiment ROSEBUD, thus concentrating and focussing effort
on cryogenic detector research in Europe into a single facility. EURECA will
use a target mass of up to one ton, enough to explore WIMP – nucleon scalar
scattering cross sections in the region of 10-9 – 10-10 picobarn.
A major advantage of EURECA is the planned use of more than just one target
material (multi target experiment for WIMP identification).
The properties of beams of high energy protons accelerated during ultraintense, picosecond laser-irradiation of thin foil targets are investigated as a function of preplasma expansion at the target front surface. Significant enhancement in the maximum proton energy and laser-to-proton energy conversion efficiency is observed at optimum preplasma density gradients, due to self-focusing of the incident laser pulse. For very long preplasma expansion, the propagating laser pulse is observed to filament, resulting in highly uniform proton beams, but with reduced flux and maximum energy.
The chlorine Heα radiation of polyvinyl chloride (PVC)
was investigated with respect to X-ray scattering experiments on dense
plasmas. The X-ray source was a laser-produced plasma that was observed
with a highly reflective highly oriented pyrolytic graphite (HOPG) crystal
spectrometer as it is used in current x-ray scattering experiments on
dense plasmas. The underlying dielectronic satellites of
Heα cannot be resolved, therefore the plasma was observed
at the same time with a focusing spectrometer with spatial resolution. To
reconstruct the spectrum a simple model to calculate the spectral line
emission based on dielectronic recombination and inner shell excitation of
helium- and lithium-like ions was used. The analysis shows that chlorine
dielectronic satellite emission is intense compared to Heα
in laser-produced chlorine plasmas with a temperature of 300 eV in this
wavelength range of Δλ = 0.07 Å (ΔE = 43 eV).
The method proposed in this paper allows deducing experimentally the role
of the underlying dielectronic satellites in the scatter spectrum measured
with a HOPG crystal spectrometer. It is shown that the dielectronic
satellites can be neglected when the scattering is measured with low
spectral resolution in the non-collective regime. They are of major
importance in the collective scatter regime where a high spectral
resolution is necessary.
We have used the Hubble Space Telescope's Advanced Camera for Surveys to measure the mass density function of morphologically-selected early-type galaxies in the Gemini Deep Deep Survey fields, over the redshift range 0.9 < z < 1.6. Our imaging data set covers four well-separated sight-lines, and is roughly intermediate (in terms of both depth and area) between the GOODS/GEMS imaging data, and the images obtained in the Hubble Deep Field campaigns. Our images contain 144 galaxies with ultra-deep spectroscopy, and they have been analyzed using a new purpose-written morphological analysis code which improves the reliability of morphological classifications by adopting a ‘quasi-petrosian’ image thresholding technique. We find that at z = 1 approximately 70% of the stars in massive galaxies reside in early-type systems. This fraction is remarkably similar to that seen in the local Universe. However, we detect very rapid evolution in this fraction over the range 1.0 < z < 1.6, suggesting that in this epoch the strong color-morphology relationship seen in the nearby Universe is beginning to fall into place.