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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.
Radio interferometric observations of extragalactic radio sources have been made with antennas at the Haystack Observatory in Massachusetts and the Owens Valley Radio Observatory in California during fourteen separate experiments distributed between September 1976 and May 1978. The components of the baseline vector and the coordinates of the sources were estimated from the data from each experiment separately. The root-weighted-mean-square scatter about the weighted mean (“repeatability”) of the estimates of the length of the 3900 km baseline was approximately 7 cm, and of the source coordinates, approximately or less, except for the declinations of low-declination sources. With the source coordinates all held fixed at the best available, a posteriori, values, and the analyses repeated for each experiment, the repeatability obtained for the estimate of baseline length was 4 cm. From analyses of the data from several experiments simultaneously, estimates were obtained of changes in the x component of pole position and in the Earth's rotation (UT1). Comparison with the corresponding results obtained by the Bureau International de l'Heure (BIH) discloses systematic differences. In particular, the trends in the radio interferometric determinations of the changes in pole position agree more closely with those from the International Polar Motion Service (IPMS) and from the Doppler observations of satellites than with those from the BIH.
1.1.1. In October 1980 the Council of the Faculty of Actuaries set up a Working Party with the following brief:—
(1) To investigate the criteria by which the solvency of life assurance companies should be assessed and to determine the amount of the solvency margin which should be required in practice by supervisory authorities. The existing requirements of the E.E.C. Life Establishment Directive should be considered with a view to recommending any desirable alterations thereto to be made when those requirements are reviewed in due course by the E.E.C. Commission. In carrying out its work the Working Party should co-operate with Working Parties or Committees of other actuarial bodies.
(2) To report the result of their investigations to Council.
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.
A systematic study has been made of the growth of both hydrogenated amorphous silicon (a-Si:H) and silicon nitride (a-SiN) by electron cyclotron resonance plasma enhanced chemical vapour deposition (ECR-PECVD). In the case of a-SiN, helium and nitrogen gas is injected into the system such that it passes through the resonance zone. These highly ionised gases provide sufficient energy to ionise the silane gas, which is injected further downstream. It is demonstrated that a gas phase reaction occurs between the silane and nitrogen species. It is control of the ratio of silane to nitrogen in the plasma which is critical for the production of stoichiometric a-SiN. Material has been produced at 80 °C with a Si:N ratio of 1:1.3 a breakdown strength of ∼6 MV cm−1 and resistivity of >1014 Ωcm. In the case of a-Si:H, helium and hydrogen gas is injected into the ECR zone and silane is injected downstream. It is shown that control of the gas phase reactions is critical in this process also. a-Si:H has been deposited at 80 °C with a dark conductivity of 10−11 Ω−1 cm−1 and a photosensitivity of just below 4×104. Such materials are suitable for use in thin film transistors on plastic substrates.
Newly developed empirical hydrocarbon potentials and self-consistent first-principles local density functional methods are used to investigate possible isomers and the electronic structure of C60H36. Within the high symmetry Th structure conjectured by the groups at Rice University there are two inequivalent sets of hydrogen atoms containing twelve and twenty-four atoms respectively. Binding each set either inside or outside of the C60 cage leads to four isomers of C60H36 with inequivalent strain energies. Although we find that placing twelve hydrogens inside the cage can lead to a metastable structure, our calculated total energies suggest that the isomer with all the hydrogens on the outside of the cage is the energetically most stable.
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.
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.
The conditions established in disordered FCC systems for predicting the slip system that will be activated by a grain boundary to relieve a local stress concentration have been applied to the ordered FCC alloy Ni3Al. The slip transfer behavior in hypo-stoichiometric Ni3Al with (0.2 at. %B) and without boron was directly observed by performing the deformation experiments in situ in the transmission electron microscope. In the boron-free and boron-doped alloys, lattice dislocations were incorporated in the grain boundary, but did not show evidence of dissociation to grain boundary dislocations or of movement in the grain boundary plane. The stress concentration associated with the dislocation pileup at the grain boundary was relieved by the emission of dislocations from the grain boundary in the boron-doped alloy. The slip system initiated in the adjoining grain obeyed the conditions established for disordered FCC systems. In the boron-free alloy, the primary stress relief mechanism was grain-boundary cracking, although dislocation emission from the grain boundary also occurred and accompanied intergranular crack advance. Because of the importance of the grain boundary chemistry in the models for explaining the boron-induced ductility in hypo-stoichiometric Ni3Al, the chemistry of grain boundaries in well-annealed boron-doped and boron-free alloys was determined by using EDS. No Ni enrichment was found at the grain boundaries examined. These observations are discussed in terms of the different models proposed to explain the ductility improvement in the boron-doped, hypo-stoichiometric alloy.
We have calculated the electronic structure of icosahedrai C60H60 and tetrahedral C60H60 via an all-electron Gaussian-orbital based local-density functional approach. The one-electron wavefunctions and eigenvalues have been used in a first-order time-dependent perturbation theoretic calculation of the spherically averaged X-ray and ultraviolet pho-toemission cross-sections for these molecules.
Recent reports suggest that graphitic tubules with diameters on the order of fullerene diameters have been synthesized. Such small-diameter tubules should have electronic properties related to those of two-dimensional graphite. We demonstrate by comparison with results from a first-principles, self-consistent, all-electron Gaussian-orbital based local-density functional approach that an all-valence tight-binding model can be expected to give a reasonable description of the electronic states of these tubules. In analyzing both high-symmetry tubules and lower-symmetry chiral tubules, we see that a relatively high carrier density could be expected for many of these structures.
Fe-Cr, Fe-Y and Fe-Cr-Y surface alloys were produced by direct ion implantation, ion beam mixing, and combinations of implantation and vapor deposition. The influence of these treatments on the oxidation behavior of iron was investigated in 1 atm. of oxygen at 520°C. The oxidation rates were less in all the ion beam alloyed iron samples than in untreated iron. The oxidation follows parabolic kinetics in most cases, with the rate constants, Kp, in the range (3-8)×10−6 mg2cm−4 sec−l versus 2.2×10−5 mg2 cm−4 sec−1 for untreated iron. Yttrium fluences between 5×1014 and 5×lO15 cm−2 did not alter the microstructures of iron significantly. However, fluences of 1×1016, 3×1016, 5x1016 and 1x1017 cm−2 caused the crystalline structure of iron to be replaced by an amorphous phase. The presence of this phase was demonstrated with selected area channeling patterns and transmission electron microscopy.
Fluences from 1×1017 to 9.6×1017 cm−2 of single and doubly charged iron ions accelerated through 170 kV were implanted into polycrystalline copper substrates at room temperature. An order of magnitude decrease in reflectivity was observed during implantation as a result of sputter-induced changes in surface topography and subsurface accumulation of iron. Both scanning electron microscopy and optical microscopy showed that the bombarded surfaces consisted of (110) and (100) grains having an intragranular, ridge-like structure. Significant height differences formed between grains as a result of their different sputtering yields. Transmission electron microscopy reveals that the implanted iron forms a face-centered-cubic metastable solid solution with the copper. Auger electron spectroscopy confirmed iron accumulation beneath the surface with maximum concentrations approaching in excess of 20 atomic percent.
Highly oriented pyrolitic graphite (HOPG) was irradiated with 1.8 MeV electrons at 45° and near grazing (86°) angles of incidence. For doses up to 1016 cm−2 the surface for the case of 45° incidence, observed by scanning tunnelling microscopy (STM), remained the same as the original sample showing only the usual periodic atomic corrugation. For near grazing incidence, at a dose of 5×10−2 cm−2, nm-hillocks are observed, some elongated along the direction of the beam incidence. These are attributed to the effects of single electron-carbon interactions in the top surface layers. At a dose of 5×1014 cm−2 (near grazing incidence) STM observations show an anomalously large (period 2.5 to 17 nm) superperiodicity superimposed on the normal 0.246 nm atomic spacing of graphite. This Moiré-like pattern suggests that the corrugations are electronic as well as topographic in origin. We propose that near grazing incidence electron irradiation causes a break-up of the surface layers into fragments, largely retaining the six-fold atomic rings, that rotate by a small angle resulting in the observed pattern by interaction with the deeper bulkstructure layers.