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Cognitive remediation (CR) training has emerged as a promising approach to improving cognitive deficits in schizophrenia and related psychosis. The limited availability of psychological services for psychosis is a major barrier to accessing this intervention however. This study investigated the effectiveness of a low support, remotely accessible, computerised working memory (WM) training programme in patients with psychosis.
Ninety patients were enrolled into a single blind randomised controlled trial of CR. Effectiveness of the intervention was assessed in terms of neuropsychological performance, social and occupational function, and functional MRI 2 weeks post-intervention, with neuropsychological and social function again assessed 3–6 months post-treatment.
Patients who completed the intervention showed significant gains in both neuropsychological function (measured using both untrained WM and episodic task performance, and a measure of performance IQ), and social function at both 2-week follow-up and 3–6-month follow-up timepoints. Furthermore, patients who completed MRI scanning showed improved resting state functional connectivity relative to patients in the placebo condition.
CR training has already been shown to improve cognitive and social function in patient with psychosis. This study demonstrates that, at least for some chronic but stable outpatients, a low support treatment was associated with gains that were comparable with those reported for CR delivered entirely on a 1:1 basis. We conclude that CR has potential to be delivered even in services in which psychological supports for patients with psychosis are limited.
Research shows that cognitive rehabilitation (CR) has the potential to improve goal performance and enhance well-being for people with early stage Alzheimer’s disease (AD). This single subject, multiple baseline design (MBD) research investigated the clinical efficacy of an 8-week individualised CR intervention for individuals with early stage AD.
Three participants with early stage AD were recruited to take part in the study. The intervention consisted of eight sessions of 60–90 minutes of CR. Outcomes included goal performance and satisfaction, quality of life, cognitive and everyday functioning, mood, and memory self-efficacy for participants with AD; and carer burden, general mental health, quality of life, and mood of carers.
Visual analysis of MBD data demonstrated a functional relationship between CR and improvements in participants’ goal performance. Subjective ratings of goal performance and satisfaction increased from baseline to post-test for three participants and were maintained at follow-up for two. Baseline to post-test quality of life scores improved for three participants, whereas cognitive function and memory self-efficacy scores improved for two.
Our findings demonstrate that CR can improve goal performance, and is a socially acceptable intervention that can be implemented by practitioners with assistance from carers between sessions. This study represents one of the promising first step towards filling a practice gap in this area. Further research and randomised-controlled trials are required.
A substantial literature has reported that stress negatively impacts on cognitive processes. As dementia caregiving can be stressful, it has been hypothesized that the challenges of dementia care may increase caregivers’ own vulnerability to cognitive decline. Prefrontal processes are thought to be most vulnerable to stress; however, few studies have examined whether greater caregiver stress predicts poorer executive dysfunction, and no previous research has considered potential moderators of this relationship. We examined (1) whether greater psychological stress mediated a relationship between caregiver stress exposure and executive functioning and (2) whether greater self-efficacy and cognitive reserve (CR) moderated this relationship.
Spousal dementia caregivers (n = 253) completed the Neuropsychiatric Inventory Questionnaire (stress exposure), the Perceived Stress Scale, the National Adult Reading Test (CR), the Fortinsky dementia-specific caregiver self-efficacy scale, and the Color Trails Test (executive functioning). Moderated mediation was tested using the PROCESS macro. Age, gender, and dementia risk factors were included as covariates.
Greater stress exposure indirectly predicted executive functioning through psychological stress. Stronger relationships between greater psychological stress and poorer executive functioning were observed among caregivers with lower CR; there was no evidence that self-efficacy moderated the relationship between stress exposure and psychological stress.
Our findings are in line with the idea that greater psychological stress in response to challenges associated with dementia care predicts poorer caregiver executive functioning, particularly among caregivers with low CR. However, these findings are cross sectional; it is also possible that poorer executive functioning contributes to greater caregiver stress.
Universal screening for postpartum depression is recommended in many countries. Knowledge of whether the disclosure of depressive symptoms in the postpartum period differs across cultures could improve detection and provide new insights into the pathogenesis. Moreover, it is a necessary step to evaluate the universal use of screening instruments in research and clinical practice. In the current study we sought to assess whether the Edinburgh Postnatal Depression Scale (EPDS), the most widely used screening tool for postpartum depression, measures the same underlying construct across cultural groups in a large international dataset.
Ordinal regression and measurement invariance were used to explore the association between culture, operationalized as education, ethnicity/race and continent, and endorsement of depressive symptoms using the EPDS on 8209 new mothers from Europe and the USA.
Education, but not ethnicity/race, influenced the reporting of postpartum depression [difference between robust comparative fit indexes (∆*CFI) < 0.01]. The structure of EPDS responses significantly differed between Europe and the USA (∆*CFI > 0.01), but not between European countries (∆*CFI < 0.01).
Investigators and clinicians should be aware of the potential differences in expression of phenotype of postpartum depression that women of different educational backgrounds may manifest. The increasing cultural heterogeneity of societies together with the tendency towards globalization requires a culturally sensitive approach to patients, research and policies, that takes into account, beyond rhetoric, the context of a person's experiences and the context in which the research is conducted.
In March 2012, a second outbreak of Cryptosporidium parvum affected children following a stay at a holiday farm in Norway; the first outbreak occurred in 2009. We studied a cohort of 145 schoolchildren who had visited the farm, of which 40 (28%) were cases. Cryptosporidium oocysts were detected in faecal samples from humans, goat kids and lambs. Molecular studies revealed C. parvum subtype IIa A19G1R1 in all samples including human samples from the 2009 outbreak. A dose–response relationship was found between the number of optional sessions with animals and illness, increasing from two sessions [risk ratio (RR) 2·7, 95% confidence interval (CI) 0·6–11·5] to six sessions (RR 8·0, 95% CI 1·7–37·7). The occurrence of two outbreaks 3 years apart, with the same subtype of C. parvum, suggests that the parasite is established in the farm's environment. We recommend greater emphasis on hand hygiene and routines related to animal contact.
Recently, multiple-locus variable-number tandem-repeat analysis (MLVA) has been proposed as an alternative to pulsed-field gel electrophoresis (PFGE) for characterization of Escherichia coli O157:H7. In this study we characterized 118 E. coli O157:H7 isolates from cases of gastrointestinal disease in New Zealand using XbaI PFGE profiles and a MLVA scheme that assessed variability in eight polymorphic loci. The 118 isolates characterized included all 80 E. coli O157:H7 referred to New Zealand's Enteric Reference Laboratory in 2006 and 29 phage-type 2 isolates from 2005. When applied to these isolates the discriminatory power of PFGE and MLVA was not significantly different. However, MLVA data may be more epidemiologically relevant as isolates from family clusters of disease had identical MLVA profiles, even when the XbaI PFGE profiles differed slightly. Furthermore, most isolates with indistinguishable XbaI PFGE profiles that did not appear to be epidemiologically related had distinct MLVA profiles.
Size-based analyses of marine animals are increasingly used to improve understanding of community structure and function. However, the resources required to record individual body weights for benthic animals, where the number of individuals can reach several thousand in a square metre, are often prohibitive. Here we present morphometric (length–weight) relationships for 216 benthic species from the North Sea to permit weight estimation from length measurements. These relationships were calculated using data collected over two years from 283 stations. For ten abundant and widely dispersed species we tested for significant spatial and temporal differences in morphometric relationships. Some were found, but the magnitude of differences was small in relation to the size-ranges of animals that are usually present and we recommend that the regression relationships given here, based on pooled data, are appropriate for most types of population and community analyses. Our hope is that the availability of these morphometric relationships will encourage the more frequent application of size-based analyses to benthic survey data, and so enhance understanding of the ecology of the benthic/demersal component of marine ecosystems and food webs.
Growing interest in nanomaterials has raised many questions regarding the operating mechanisms active during the deformation and failure of nanoscale materials. To address this, a simple, effective in situ TEM straining technique was developed that provides direct detailed observations of the active deformation mechanisms at a length scale relevant to most nanomaterials. The capabilities of this new straining structure are highlighted with initial results in pulsed laser deposited (PLD) Al-Al2O3 thin films of uniform thickness. The Al-Al2O3 system was chosen for investigation, as the grain size can be tailored via deposition and annealing conditions and the active mechanisms in the binary system can be compared to previous studies in PLD Ni and evaporated Al films. PLD Al-Al2O3 free-standing films of various oxide concentrations and different thermal histories were produced and characterized in terms of average grain and particle sizes. Preliminary in situ TEM straining experiments show intergranular failure for films with 5 vol% Al2O3. Further work is in progress to explore and understand the active deformation and failure mechanisms, as well as the dependence of mechanisms on processing routes.
In May 1992. a small, circumscribed community outbreak of infection due to verotoxin-producing Escherichia coli O157 phage type 49 occurred in a semi-rural area of south-east Scotland. On the basis of stool cultures, six cases were identified, one of whom was asymptomatic. One child developed the haemolytic uraemic syndrome. Although the source of infection of the index case was not established nor could the extent of person-to-person spread be fully determined, the clinical, microbiological and epidemiological evidence available indicated that a children's paddling pool served as the focal point in the transmission of infection causing the outbreak.
Little information exists on treatment effectiveness in antisocial personality disorder (ASPD). We investigated the feasibility and effectiveness of carrying out a randomized controlled trial of cognitive behaviour therapy (CBT) in men with ASPD who were aggressive.
This was an exploratory two-centre, randomized controlled trial in a community setting. Fifty-two adult men with a diagnosis of ASPD, with acts of aggression in the 6 months prior to the study, were randomized to either treatment as usual (TAU) plus CBT, or usual treatment alone. Change over 12 months of follow-up was assessed in the occurrence of any act of aggression and also in terms of alcohol misuse, mental state, beliefs and social functioning.
The follow-up rate was 79%. At 12 months, both groups reported a decrease in the occurrence of any acts of verbal or physical aggression. Trends in the data, in favour of CBT, were noted for problematic drinking, social functioning and beliefs about others.
CBT did not improve outcomes more than usual treatment for men with ASPD who are aggressive and living in the community in this exploratory study. However, the data suggest that a larger study is required to fully assess the effectiveness of CBT in reducing aggression, alcohol misuse and improving social functioning and view of others. It is feasible to carry out a rigorous randomized controlled trial in this group.
The deformation and failure processes in ultra-fine and nanograined metals over different length scales have been probed using transmission electron microscopy (TEM) and scanning electron microscopy (SEM) in combination with a micromechanical in situ straining device. This novel straining device affords the opportunity to directly correlate the macroscopic mechanical properties with the microscopic deformation and failure mechanisms. Through use of this device it has been shown that increased film thickness results in a transition between limited plasticity and intergranular fracture to global plasticity and shear failure for deposited aluminum samples of similar grain size but different thickness.
Retention of the enhanced properties reported for nanograined metallic systems requires that the nanostructure be insensitive to temperature and deformation. In situ transmission electron microscopy annealing experiments were employed to investigate the structural changes associated with the formation of micron-sized grains in nanograined evaporated gold thin films. This abnormal grain growth occurs randomly throughout the film. Twinning but not dislocation slip occurs in the growing grains until the grain size is in the hundreds of nanometer range. The twins appear to hinder growth and for grain growth to continue the twins must either be annihilated or be able to grow with the grain concurrently.
Poly(vinylidene fluoride) (PVdF) fine fiber of 200–300 nm in diameter was prepared through the electrospinning process. Dehydrofluorination of PVdF-based fibers for making infusible fiber was carried out using DBU, and the infusible PVdF-based nanofibers were then carbonized at 900–1800°C. The structural properties and morphologies of the resulting carbon nanofibers were investigated using XRD, Raman IR, SEM, TEM, and surface area & pore analysis. The PVdF-based carbon nanofibers had rough surfaces composed of 20-to 30-nm granular carbons, indicating their high surface area in the range of 400–970 m2/g. They showed amorphous structures. In the case of the highly ehydrofluorinated PVdF fiber, the resulting carbon fiber had a smoother surface, with d002 = 0.34–0.36 nm, and a very low surface area of 16–33 m2/g. The hydrogen storage capacities of the above carbon nano-fibers were measured, using the gravimetric method, by magnetic suspension balance (MSB), at room temperature and at 100 bars. The storage data were obtained after the buoyancy correction. The PVdF-based microporous carbon nanofibers showed a hydrogen storage capacity of 0.04–0.4 wt%. The hydrogen storage capacity depended on the dehydrofluorination of the PVdF nanofiber precursor, and on the carbonization temperatures.
Electrospun PAN nanofibers were carbonized with or without iron(III) acetylacetonate to induce catalytic graphitization within the range of 900–1500°C, resulting in ultrafine carbon fibers with the diameter of about 90–300 nm. The structural properties and morphologies of the resulting carbon nanofibers were investigated using XRD, Raman IR, SEM, TEM, and surface area/pore analysis. The PAN-based carbon nanofibers carbonized without a catalyst had amorphous structures, with d002 = 0.37 nm, and smooth surfaces with very low surface areas of 22–31 m2/g. The carbonization of PAN-based nanofibers in the presence of the catalyst produced the graphite nanofibers (GNF) with d002 = 0.341 nm, indicating turbostrate structures. The graphite structures were grown by increasing the catalyst contents and the carbonization temperature. The hydrogen storage capacities of the aforementioned carbon nanofiber materials were evaluated through the gravimetric method using Magnetic Suspension Balance (MSB) at room temperature and at 100 bars. The storage data were obtained after the buoyancy correction. The CNFs showed hydrogen storage capacities of 0.16–0.50 wt.%, increasing with the increase of carbonization temperature, but that of the CNF at 1500°C was lowest. The hydrogen storage capacities of the GNFs with low surface areas of 100–250m2/g were 0.14–1.01 wt%.
Sodium alanate was milled with and without TiCl3. The hydrogen release and uptake was measured during temperature-programmed absorption and desorption, as well as by isothermal charging and discharging, using a Sieverts' type apparatus. These data were supplemented by in-situ X-ray diffraction studies of hydrogen desorption. Rate constants derived from XRD were slower than those derived from volumetric H2 measurements. Al formation observed in XRD exceeded that expected from the observed decomposition of NaAlH4 and Na3AlH6.
The hydrogen storage properties of nanostructured Mg and MgH2 thin films were studied as created by Ar and Ar+H2 plasma sputter deposition. Columnar structures with typical widths of ∼120 nm are observed with their long columnar axis extending throughout the thickness of the films. Applying substrate bias voltages during deposition results in narrower columns. A concomitant reduction in hydrogen desorption temperature from 400 °C to 360 °C is observed. Capping the Mg films with a ∼100 nm thin Pd layer leads to significantly reduced hydrogen desorption temperatures of ∼200 °C induced by the catalytic activity of the Pd cap layer. Also, hydrogen permeation of the films is strongly improved. The rate-determining factor is found to be the dissociation of the hydrogen molecules. Optimum hydrogen loading conditions of the Pd/Mg films were obtained just above ∼200 °C at hydrogen pressures of 0.25–1.0 MPa, resulting in hydrogen storage capacities in the range of 4–7 wt%.
Hydrogen adsorption has been observed with a binding energy of ∼ 50 kJ /mol on as-synthesized carbon multi-wall nanotubes (MWNTs). The MWNTs are virtually free of non-nanotube carbon impurities but contain residual iron catalyst particles. The MWNTs are also highly graphitic. No hydrogen adsorption is observed at near ambient temperatures for purified MWNTs that are free of iron particles. However, hydrogen adsorption is also not observed on bare iron particles even following reduction in the presence of hydrogen at 775 K. These results imply that a special synergy occurs when small iron particles or atoms are in intimate contact with sp2-hybridized aromatic carbon. Interestingly, reducing the as-synthesized MWNTs in H2 at 573 K results in an increased hydrogen capacity. Understanding this hydrogen storage mechanism could facilitate the economical engineering of a hydrogen storage material that meets the United States Department of Energy targets for vehicular fuel cell applications. Recent theoretical studies have shown that an iron ad atom forms a complex with a C36 fullerene and shares charge with four carbon atoms of a bent five-membered ring. Three H2 ligands then coordinate with the iron forming a stable 18-electron organometallic complex. Here the binding energy of the molecular hydrogen ligands is ∼43 kJ /mol. These theoretical results could possibly explain the unique hydrogen storage properties of MWNTs that are grown with an iron catalyst.