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Tart Montmorency cherries (MC) are a particularly rich source of anthocyanins and other polyphenols that have been shown to elicit antioxidant, anti-inflammatory and vasomodulatory actions. The current study aimed to determine the influence of chronic MC supplementation on cognitive function and mood. In a 3-month double-blinded, placebo-controlled parallel study, middle-aged adults (mean ± sd: 48 ± 6 years) were randomly assigned to either 30 ml twice daily of MC (n 25) or the same amount of an isoenergetic placebo (n 25). Cognitive function and mood were assessed before and after supplementation using a computerised cognitive task battery and visual analogue scales. Cerebral blood flow was also monitored by near-infrared spectroscopy during the task battery, and questionnaires were administered to determine subjective sleep and health status and plasma metabolomics were analysed before and after supplementation. After 3 months, the MC resulted in higher accuracy in digit vigilance (mean difference: 3·3, 95 % CI: 0·2, 6·4 %) with lower number of false alarms (mean difference: −1·2, 95 % CI: −2·0, −0·4) compared with the placebo. There was also a treatment effect for higher alertness (mean difference: 5·9, 95 % CI: 1·3, 10·5 %) and lower mental fatigue ratings (mean difference −9·5, 95 % CI: −16·5, −2·5 %) with MC. Plasma metabolomics revealed an increase in a number of amino acids in response to MC intake, but not placebo. These data suggest an anti-fatiguing effect of MC supplementation as well as the ability to improve sustained attention during times of high cognitive demand, this could be related to changes in amino acid metabolism.
In the winter of 2016 I partook in a tour of the front lines facing the Dawla al Islamia, the Islamic State, in northern Iraq. Two years earlier ISIS had burst on to the world stage and conquered vast swathes of territory in a now borderless region known as ‘Syraq’. In 2014, Iraq alone suffered a third of the world’s terrorism fatalities. But not all these deaths came at the hands of ISIS or its predecessor ‘Al Qaeda in Iraq’. With Sunni ISIS garnering attention as the world’s most deadly terrorist group, less attention has been paid to the terror campaign carried out by Shiite groups that was launched, in part, as a response to the terror campaign by Sunni Al Qaeda in Iraq (AQI) and ISIS. Many observers who commented on this wave of terrorism described the spectacular rise of ISIS in 2012–14 and emergence of Iranian-backed Iraqi Shiite terrorist groups as coming ‘out of the blue’. But there was a long and rarely studied prehistory to the rise of terrorism in this land that begins with the 2003 US–British invasion of this secular, Baathist-dominated country that had previously served as ‘firewall’ against both Shiite and Sunni sectarian radicalism. An understanding of this background history and the role of 2003’s Operation Iraqi Freedom in opening the Pandora’s box of sect-based terrorism in Iraq is crucial to explaining the origins, goals, tactics and local and global impact of the terrorists operating in this land.
Background: Cognitive Behavioural Therapy (CBT) aims to teach people skills to help them self-manage their depression. Trial evidence shows that CBT is an effective treatment for depression and individuals may experience benefits long-term. However, there is little research about individuals’ continued use of CBT skills once treatment has finished. Aims: To explore whether individuals who had attended at least 12 sessions of CBT continued to use and value the CBT skills they had learnt during therapy. Method: Semi-structured interviews were held with participants from the CoBalT trial who had received CBT, approximately 4 years earlier. Interviews were audio-recorded, transcribed and analysed thematically. Results: 20 participants were interviewed. Analysis of the interviews suggested that individuals who viewed CBT as a learning process, at the time of treatment, recalled and used specific skills to manage their depression once treatment had finished. In contrast, individuals who viewed CBT only as an opportunity to talk about their problems did not appear to utilize any of the CBT skills they had been taught and reported struggling to manage their depression once treatment had ended. Conclusions: Our findings suggest individuals may value and use CBT skills if they engage with CBT as a learning opportunity at the time of treatment. Our findings underline the importance of the educational model in CBT and the need to emphasize this to individuals receiving treatment.
Background: Cognitive behaviour therapy (CBT) for patients with treatment-resistant depression (TRD) aims to reframe underlying conditional beliefs that are thought to maintain depression. Aim: To systematically explore conditional beliefs expressed by primary-care based patients with TRD, defined as non-response to at least 6 weeks of antidepressants. Method: Conditional beliefs (stated in an “If. . .then. . .” format) were extracted from a random sample of 50 sets of therapist notes from the CoBalT trial, a large randomized controlled trial of CBT for TRD in primary care. The beliefs were separated into their two constituent parts; the demands (Ifs) and consequences (thens). An approach based on framework analysis provided a systematic way of organizing the data, and identifying key themes. Results: Four main themes emerged from the demand part of the conditional beliefs (Ifs): 1. High standards; 2. Putting others first/needing approval; 3. Coping; and 4. Hiding “true” self. Three main themes emerged from the consequence part of the conditional beliefs (thens): 1. Defectiveness; 2. Responses of others; 3. Control of emotions. Conclusions: Identifying common themes in the conditional beliefs of patients with TRD adds to our clinical understanding of this client group, providing useful information to facilitate the complex process of collaborative case conceptualization and working with conditional beliefs within CBT interventions.
Depression is expensive to treat, but providing ineffective treatment is more expensive. Such is the case for many patients who do not respond to antidepressant medication.
To assess the cost-effectiveness of cognitive–behavioural therapy (CBT) plus usual care for primary care patients with treatment-resistant depression compared with usual care alone.
Economic evaluation at 12 months alongside a randomised controlled trial. Cost-effectiveness assessed using a cost-consequences framework comparing cost to the health and social care provider, patients and society, with a range of outcomes. Cost-utility analysis comparing health and social care costs with quality-adjusted life-years (QALYs).
The mean cost of CBT per participant was £910. The difference in QALY gain between the groups was 0.057, equivalent to 21 days a year of good health. The incremental cost-effectiveness ratio was £14 911 (representing a 74% probability of the intervention being cost-effective at the National Institute of Health and Care Excellence threshold of £20 000 per QALY). Loss of earnings and productivity costs were substantial but there was no evidence of a difference between intervention and control groups.
The addition of CBT to usual care is cost-effective in patients who have not responded to antidepressants. Primary care physicians should therefore be encouraged to refer such individuals for CBT.
Some of the most pressing debates in development studies have concerned the relative merits of states and markets, or the means by which markets might be regulated by a range of public institutions from the local to the global scale. These debates have taken shape, most famously, in the contrasting cases of sub-Saharan Africa and East Asia, and they have an obvious and continuing relevance in countries as diverse as Brazil, Nigeria, India and China. Yet if debate on these issues continues to be fierce, there appears to be general agreement that ‘strong states’ or ‘free markets’ need to be kept in check by vibrant civil societies. Indeed, it is a common proposition in development studies that this hazy zone of ‘freedom’ between the family and the state is a source of unparalleled strength for ordinary men and women, and a source of development itself and even economic growth.
Robert Putman has made this claim as strongly as anyone. His suggestion that economic growth is promoted by a prior build-up of social capital – of people's engagements with a dense network of civic associations – has become a staple of World Bank thinking since the mid-1990s. Even where the causal propositions of Putnam are refused, it is clear that the virtues of civil society are widely admired. Arturo Escobar looks to civil society as a breeding ground for oppositional movements and experiments. It functions for him, and perhaps also for Ashis Nandy in India, as a potential zone of resistance to the dehumanizing claims of developmentalism.
Molecular variables, using aqueous and alkaline extracts, of the polysaccharide from ispaghula husk (IH) were examined using gel-permeation chromatography linked to multi-angle laser light scattering. Progressive extraction can yield a component with a molecular weight (MW) value up to about 7×106 Da, and gels, which accompany the extraction, have MW ranging from 10–20× 106 Da. To mimic the polysaccharide degradation, particularly in the colon, the solid IH was degraded progressively using ionising radiation. A chain break occurs every 7.5 kGy in NaOH and every 15 kGy in water. The solid-state matrix is opened by the radiation to yield increased visco-elasticity of the aqueous extracts at critical radiation doses, before further degradation occurs after about 12 kGy. Differential scanning calorimetry is used to study the mechanism of interaction of water with IH. The first water to be taken up is non-freezing water and represents about twelve water molecules/disaccharide unit of the polysaccharide. As the water content is increased, the water becomes bound to the polysaccharide and freezes and melts at a temperature different from free water. This water is thermodynamically distinguishable from free water. It forms amorphous ice on cooling which crystallises exothermically and subsequently melts endothermically. Saturation occurs at a water content of 2–3 g water/g polymer, showing that about 60% of the water in the system is ‘bound’. The most surprising conclusion is that despite the fact that the IH swells in water to form a solid and stiff gel, the greater part of that water in the gel is still free and behaves like liquid water.
Monodisperse latex microspheres ranging in size from submicrometer to several micrometers in diameter can be prepared in the laboratory. The uniformity of diameter is important for instrument calibration and other applications. However it has proved very difficult to manufacture commercial quantities of mondisperse latex microspheres with diameters larger than about 3 micrometers owing to buoyancy and sedimentation effects. In an attempt to eliminate these effects NASA sponsored a Space Shuttle experiment called the Monodisperse Latex Reactor (MLR) to produce these monodisperse microspheres in larger sizes in microgravity. Results have been highly successful.
Using technology gained from this space experiment, a ground-based rotating latex reactor has been fabricated in an attempt to minimize sedimentation without using microgravity. The entire reactor cylinder is rotated about a horizontal axis to keep the particles in suspension.
In this paper we determine the motion of small spherical particles under gravity, in a viscous fluid rotating uniformly about a horizontal axis. The particle orbits are approximately circles, with centres displaced horizontally from the axis of rotation. Owing to net centrifugal buoyancy, the radius of the circles increases (for heavy particles) or decreases (for light particles) with time, so that the particles gradually spiral inward or outward.
For a large rotation rate, the particles spiral outwards or inwards too fast, while for a small rotation rate, the displacement of the orbit centre from the rotation axis is excessive in relation to the reactor radius. We determine the rotation rate that maximizes the fraction of the reactor cross-section area that contains particles that will not spiral out to the wall in the experimental time (for heavy particles), or that have spiralled in without hitting the wall (for light particles). Typically, the rate is close to 1 r.p.m., and design rotation rate ranges should span this value.
The discipline of development studies does not have a good reputation among students of post-colonialism. Indeed, it is hard to think of two intellectual and political traditions that are further removed. Post-colonial scholars are deeply suspicious of the Eurocentric and depoliticizing instincts of development studies. This is a common thread in the work of Partha Chatterjee, Arturo Escobar and James Ferguson, however much they are divided on the possibility of development ‘itself’. Chatterjee and Ferguson do not fully share Escobar's pessimism about the past fifty years: the age of misdevelopment that supposedly brought about only famine, debts and immiseration. But they do insist that the ambitious plans of the development industry are repeatedly frustrated by structures of power and politics that are opposed to easy talk of citizenship, good governance and benign economic growth.
In the everyday worlds of ‘popular politics’, Chatterjee maintains, deals are struck by poorer people with those who mediate for them in exchanges with the state and governmental agencies. This is the dirty and sometimes dangerous world of political society. For Ferguson, meanwhile, the necessary and repeated failure of development projects to secure their stated aims is linked to the extension of state power over potentially rebellious populations. The development business, and the counterpart discipline of development studies, is neither ineffective nor especially insincere, but its power effects are often profoundly disempowering for poorer people.
Michel Foucault once told an interviewer that it was important to be humble in the face of apparent social irruptions. We should be properly alert, he said, to continuities of history and geography, and not constantly on the look out for markers of ‘the new’ or what today might be called ‘the post-’. This is surely good advice, and we need to bear it in mind when discussing issues like participation and good governance. The idea that states in the past have not been concerned with good government is clearly wrong. The emergence of biopolitics is one strong indicator of the responsibilities that governments are meant to have to their populations. Nevertheless, there is a strong perception in the development community that state failure and bad governance have become important issues since the 1970s, and this perception has been linked to a broader critique of rent-seeking behaviour, simple predation, and dirigiste development.
In the next part of the chapter we review some of the debates that have attended the rise of the good governance agenda. We shall also follow Adrian Leftwich and Rob Jenkins in drawing attention to the ways in which the agendas of good governance can be said to depoliticize accounts of development and rule. They do so, not least, by refusing to pay close attention to questions of state capabilities, and the incapacity of some regimes to secure control over their territories.
In recent years there has been a sea-change in the ways in which the state in India has sought to present itself to its poorest citizens. To listen to leading members of the National Democratic Alliance (NDA) government in 2004 one would think that the year 2000 (or even 2001 or 2002) was something like Ground Zero in this respect. Ministers from leading human development departments were in the habit of swatting away criticism of their ministries on the ground that everything was in flux. In a world of village education committees, citizen scorecards and newly vibrant panchayati raj institutions, not to mention a new era of public–private partnerships, it apparently made no sense to criticize ministers for faults that may or may not have dogged previous administrations.
This was nonsense, of course, for many of the innovations that were being trumpeted by the NDA were first given shape by the Congress and United Front governments of the 1990s, when village education committees and joint forest management were launched with appropriate pomp and fanfare. It would also be unwise to assume that new rhetoric about a kinder and more responsive system of government must correspond in any clear way to the perceptions of poorer or more vulnerable people. All democratic governments are tempted by the fruit of exaggeration, and Partha Chatterjee is right to insist that poorer people in ‘most of the world’ (2004: 3) are very often compelled to meet the state as members of social groups ‘that transgress the strict lines of legality in struggling to live and work’ (Chatterjee 2004: 40).
Special employment and poverty alleviation programmes
(a) Rural self-employment programmes
IRDP Integrated Rural Development Programme
50% centrally sponsored scheme with national coverage since 1980 (1976–80 pilot scheme in selected Blocks). Aims at providing self-employment through acquisition of productive assets and skills through provision of subsidy and bank credit. Targeted at rural BPL population, largely small and marginal farmers, agricultural labourers and rural artisans. Special safeguards for SC/STs, women, physically handicapped; priority to assignees of ceiling surplus land, Green Card holders under Family Welfare Programme and freed bonded labourers. Performance during Eighth Plan: total allocation (Centre and State) = Rs. 5,048 crores; 108 lakh families covered.
TRYSEM Training of Rural Youth for Self-Employment
50% centrally sponsored facilitating component of IRDP since 1979. Aims at providing basic technical and managerial skills through training. Targeted at rural BPL population between 18 and 35 years. Special safeguards for SC/STs and others, like IRDP. Performance during Eighth Plan: total allocation (Centre and State) = Rs. 370 crores; 15 lakh youth trained.
DWCRA Development of Women and Children in Rural Areas
Sub-scheme of IRDP started in 1982–3 on pilot basis, later extended to all Districts. Aims at improving living conditions of women and, thereby, of children by promoting women's income-generation activities through self-help groups and providing access to basic social services. Targeted at groups of 10 to 15 women among BPL families. 50% to SC/STs. Performance during Eighth Plan: total allocation (Centre and State) = Rs. 190 crores; 1.9 lakh groups formed; 30 lakh beneficiaries.