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Cognitive-behavioural therapy (CBT) is an effective treatment for depressed adults. CBT interventions are complex, as they include multiple content components and can be delivered in different ways. We compared the effectiveness of different types of therapy, different components and combinations of components and aspects of delivery used in CBT interventions for adult depression. We conducted a systematic review of randomised controlled trials in adults with a primary diagnosis of depression, which included a CBT intervention. Outcomes were pooled using a component-level network meta-analysis. Our primary analysis classified interventions according to the type of therapy and delivery mode. We also fitted more advanced models to examine the effectiveness of each content component or combination of components. We included 91 studies and found strong evidence that CBT interventions yielded a larger short-term decrease in depression scores compared to treatment-as-usual, with a standardised difference in mean change of −1.11 (95% credible interval −1.62 to −0.60) for face-to-face CBT, −1.06 (−2.05 to −0.08) for hybrid CBT, and −0.59 (−1.20 to 0.02) for multimedia CBT, whereas wait list control showed a detrimental effect of 0.72 (0.09 to 1.35). We found no evidence of specific effects of any content components or combinations of components. Technology is increasingly used in the context of CBT interventions for depression. Multimedia and hybrid CBT might be as effective as face-to-face CBT, although results need to be interpreted cautiously. The effectiveness of specific combinations of content components and delivery formats remain unclear. Wait list controls should be avoided if possible.
This paper reports on a funded summit, which convened a multidisciplinary group of experts to provide consensus on the research priorities necessary for improving long-term community integration of individuals with traumatic brain injury (TBI) and their caregivers.
The 2-day summit was directed using the World Café Methodology, to engage stakeholders and collaboratively arrive at a consensus on the problems to be targeted in research. Participants (n=54), drawn from two Canadian provinces, included an interdisciplinary group of researchers, clinicians, representatives from brain injury associations, individuals with TBI, and caregivers. In small groups, participants discussed challenges to long-term community integration and potential initiatives that would address these barriers. Field notes from the discussions were analyzed using qualitative content analysis.
The consensus on prioritized research directions included developing interventions to optimize the functioning and participation of individuals with TBI, reducing caregiver burden, and evaluating how emerging technology can facilitate delivery of care.
The World Café Methodology was an effective method for developing research priorities. The breadth of expertise of participants and the collegial environment allowed for the identification of a broad perspective on important future research directions with potential to enhance the long-term community integration of individuals with brain injury.
An experiment was carried out to examine the effects of offering beef cattle five silage diets. These were perennial ryegrass silage (PRGS) as the sole forage, tall fescue/perennial ryegrass silage (FGS) as the sole forage, PRGS in a 50:50 ratio on a dry matter (DM) basis with lupin/triticale silage (LTS), lupin/wheat silage (LWS) and pea/oat silage (POS). Each of the five silage diets was supplemented with 4 and 7 kg of concentrates/head/day in a five silages × two concentrate intakes factorial design. A total of 90 cattle were used in the 121-day experiment. The grass silages were of medium digestibility and were well preserved. The legume/cereal silages had high ammonia N, high acetic acid, low lactic acid, low butyric acid and low digestible organic matter concentrations (542, 562 and 502 g/kg DM for LTS, LWS and POS, respectively). Silage treatment did not significantly affect liveweight gain, carcass gain, carcass characteristics, the instrumental assessment of meat quality or fatty acid composition of the M. longissimus dorsi muscle. In view of the low yields of the legume/cereal crops, it is concluded that the inclusion of spring-sown legume/cereal silages in the diets of beef cattle is unlikely to be advantageous.
An experiment was carried out to examine the effects of offering beef steers grass silage (GS) as the sole forage, lupins/triticale silage (LTS) as the sole forage, a mixture of LTS and GS at a ratio of 70:30 on a dry matter (DM) basis, vetch/barley silage (VBS) as the sole forage, a mixture of VBS and GS at a ratio of 70:30 on a DM basis, giving a total of five silage diets. Each of the five silage diets was supplemented with 2 and 5 kg of concentrates/head/day in a 5 × 2 factorial design to evaluate the five silages at two levels of concentrate intake and to examine possible interactions between silage type and concentrate intake. A total of 80 beef steers were used in the 122-day experiment. The GS was well preserved while the whole crop cereal/legume silages had high ammonia-nitrogen (N) concentrations, low lactic acid concentrations and low butyric acid concentrations For GS, LTS, LTS/GS, VBS and VBS/GS, respectively, silage DM intakes were 6.5, 7.0, 7.2, 6.1 and 6.6 (s.e.d. 0.55) kg/day and live weight gains were 0.94, 0.72, 0.63, 0.65 and 0.73 (s.e.d. 0.076) kg/day. Silage type did not affect carcass fatness, the colour or tenderness of meat or the fatty acid composition of the intramuscular fat in the longissimus dorsi muscle.
Vaccination remains a mainstay of companion animal population health. However, how vaccine use at a population level complies with existing guidelines is unknown. Here we use electronic health records to describe vaccination in dogs, cats and rabbits attending a large sentinel network of UK veterinary practices. In total, 77.9% (95% CI: 77.6–78.1) of animals had recorded vaccinations. The percentage of animals with recorded vaccinations was higher in dogs, neutered animals, in insured dogs and cats and in purebred dogs. Vaccination rates varied in different regions of Great Britain in all species. Dogs and cats belonging to owners living in less deprived areas of England and Scotland were more likely to be recorded as vaccinated. In the vaccinated population, cats received more core vaccines per year of life (0.86) than dogs (0.75), with feline leukaemia vaccines almost as frequent as core vaccines. In dogs, leptospira vaccines were more frequent than core vaccines. This descriptive study suggests a substantial proportion of animals are not benefiting from vaccine protection. For the first time, we identify potential factors associated with variations in recorded vaccination frequency, providing a critical baseline against which to monitor future changes in companion animal vaccination and evidence to inform future targeted health interventions.
Adipose tissue becomes more saturated and less unsaturated with age (Kemp et al., 1981). Desaturation of stearic acid to the oleic acid is catalysed by stearoyl-CoA desaturase (SCD) and increasing the degree of desaturation of lamb is likely to be beneficial in terms of human nutrition. By altering the levels of ovine SCD mRNA, the supply of oleic acid to the tissue could be manipulated, resulting in a practical method of changing the fatty acid profile of the animals meat. Previous work in our laboratory has shown variability between adipose tissue depots in their expression of SCD and that this variability is associated with changes in oleic acid content (Daniel et al, 2004). Such differences in SCD expression between depots implies that there may be even larger variation in SCD expression between breeds. A sheep breed with particularly high level of SCD mRNA could then be exploited through breeding programmes to produce animals with increased desaturase activity and therefore increased oleic acid content. Three sheep breeds, Texel, Beulah and Soay, were therefore used to study the influence of breed and age on SCD expression.
A considerable proportion of beef produced in the UK is a byproduct of the dairy industry. Young animals from this source are generally regarded as low in quality and meat from animals of this type is usually destined for the commodity minced beef market. The objective of the present study was to evaluate the effect of slaughter weight on sensory characteristics of meat from Holstein-Friesian bulls and steers offered a cereal-based ration.
Data from the US (Van Amburgh et al., (2001)) suggests that the current UK recommendations for feeding the neonatal calf (˜500g milk replacer/d, at ˜230 g crude protein per kg fresh milk powder) are inadequate to sustain high growth rates in early life. It has been suggested that increasing nutrition during the first 6-8 weeks of the calf’s life will improve lifetime production, health and fertility. An experiment was therefore initiated to investigate the influence of level of milk replacer feeding and the crude protein content of the milk replacer on calf performance during the first 8 weeks of life, under UK conditions.
Results of a recent study (Wicks et al. 2005) indicate that increasing the protein content of the milk replacer fed to autumn-born Holstein-Friesian calves reduced growth rates in the first 8 weeks of life. Van Amburgh et al., (2001) previously suggested that increasing both milk replacer intake and protein content maximised the growth of calves during this early phase of life. An experiment was undertaken to investigate the influence of level of milk replacer and crude protein content on calf performance during the first 8 weeks of life of spring-born calves.
Wilting of grass prior to ensiling generally produces positive responses in dry matter (DM) intake of cattle, but the responses in animal performance are often small, or even negative. The primary objective of the present study was to compare energy utilization from heavily wilted and unwilted silages by growing cattle when given at equal metabolisable energy (ME) intakes. A secondary objective was to evaluate effects of silage additive type (inoculant v. formic acid) on energy utilization.
Four silages were produced from unwilted and wilted grasses (DM 193 and 450 g/kg) obtained from a perennial ryegrass sward. The wilted grass was dried in the field for 26 hours using rapid wilting techniques involving crop conditioning and spreading. At ensiling both the unwilted and wilted grasses were each treated with two additives, a bacterial inoculant (Ecosyl, Zeneca Bioproducts Limited) and a formic acid additive (ADD-F, BP Chemicals Ltd.).
Accurate forecasting of seasonal influenza epidemics is of great concern to healthcare providers in temperate climates, since these epidemics vary substantially in their size, timing and duration from year to year, making it a challenge to deliver timely and proportionate responses. Previous studies have shown that Bayesian estimation techniques can accurately predict when an influenza epidemic will peak many weeks in advance, and we have previously tailored these methods for metropolitan Melbourne (Australia) and Google Flu Trends data. Here we extend these methods to clinical observation and laboratory-confirmation data for Melbourne, on the grounds that these data sources provide more accurate characterizations of influenza activity. We show that from each of these data sources we can accurately predict the timing of the epidemic peak 4–6 weeks in advance. We also show that making simultaneous use of multiple surveillance systems to improve forecast skill remains a fundamental challenge. Disparate systems provide complementary characterizations of disease activity, which may or may not be comparable, and it is unclear how a ‘ground truth’ for evaluating forecasts against these multiple characterizations might be defined. These findings are a significant step towards making optimal use of routine surveillance data for outbreak forecasting.
Ground-state OH masers identified in the Southern Parkes Large-Area Survey in Hydroxyl were observed with the Australia Telescope Compact Array to obtain positions with high accuracy (~1 arcsec). We classified these OH masers into evolved star OH maser sites, star formation OH maser sites, supernova remnant OH maser sites, planetary nebula OH maser sites and unknown maser sites using their accurate positions. Evolved star and star formation OH maser sites in the Galactic Centre region (between Galactic longitudes of −5° to +5° and Galactic latitudes of −2° and +2°) were studied in detail to understand their distributions.
The statistics of the velocity gradient tensor
, which embody the fine scales of turbulence, are influenced by turbulent ‘structure’. Whilst velocity gradient statistics and dynamics have been well characterised, the connection between structure and dynamics has largely focused on rotation-dominated flow and relied upon data from numerical simulation alone. Using numerical and spatially resolved experimental datasets of homogeneous turbulence, the role of structure is examined for all local (incompressible) flow topologies characterisable by
. Structures are studied through the footprints they leave in conditional averages of the
field, pertinent to non-local strain production, obtained using two complementary conditional averaging techniques. The first, stochastic estimation, approximates the
field conditioned upon
and educes quantitatively similar structure in both datasets, dissimilar to that of random Gaussian velocity fields. Moreover, it strongly resembles a promising model for velocity gradient dynamics recently proposed by Wilczek & Meneveau (J. Fluid Mech., vol. 756, 2014, pp. 191–225), but is derived under a less restrictive premise, with explicitly determined closure coefficients. The second technique examines true conditional averages of the
field, which is used to validate the stochastic estimation and provide insights towards the model’s refinement. Jointly, these approaches confirm that vortex tubes are the predominant feature of rotation-dominated regions and additionally show that shear layer structures are active in strain-dominated regions. In both cases, kinematic features of these structures explain alignment statistics of the pressure Hessian eigenvectors and why local and non-local strain production act in opposition to each other.
SPLASH (the Southern Parkes Large-Area Survey in Hydroxyl) is a deep survey of ground-state OH absorption and emission from the Galactic Plane, as well as an unbiased search for OH masers. Key early results include the detection of a rich and complex distribution of diffuse, optically thin OH with strongly non-thermal excitation temperatures, and the detection of numerous new maser sources. The survey aims to use OH as a probe of CO-dark H2 ISM Galactic scales, with future plans including comprehensive comparisons with CO and Hi, as well as non-LTE excitation modelling of the four ground-state lines.
The intensity ratios of HCO+/HCN and HNC/HCN (1-0) reveal the relative influence of star formation and active galactic nuclei (AGN) or black holes on the circum-nuclear gas of a galaxy, allowing the identification of X-ray dominated regions (XDRs) and Photon-dominated regions (PDRs). It is not always clear in the literature how this intensity ratio calculation has been, or should be performed. This paper discusses ratio calculation methods for interferometric data.
We present results from a Mopra 7 mm-wavelength survey that targeted the dense gas-tracing CS(1-0) transition towards the young γ-ray-bright supernova remnant, RX J1713.7–3946 (SNR G 347.3−0.5). In a hadronic γ-ray emission scenario, where cosmic ray (CR) protons interact with gas to produce the observed γ-ray emission, the mass of potential CR target material is an important factor. We summarise newly discovered dense gas components, towards Cores G and L, and Clumps N1, N2, N3, and T1, which have masses of 1 – 104 M⊙. We argue that these components are not likely to contribute significantly to γ-ray emission in a hadronic γ-ray emission scenario. This would be the case if RX J1713.7–3946 were at either the currently favoured distance of ~1 kpc or an alternate distance (as suggested in some previous studies) of ~6 kpc.
This survey also targeted the shock-tracing SiO molecule. Although no SiO emission corresponding to the RX J1713.7–3946 shock was observed, vibrationally excited SiO(1-0) maser emission was discovered towards what may be an evolved star. Observations taken 1 yr apart confirmed a transient nature, since the intensity, line-width, and central velocity of SiO(J = 1-0,v = 1,2) emission varied significantly.
A cloud monitor has been developed for use with cosmic ray air shower fluorescence detectors, the High Resolution Fly's Eye and the Pierre Auger Observatory. This is based on an infrared thermopile device which, unlike previous such monitors, requires no moving chopper and is suitable for unattended operation over long periods of time.
The accumulation, compression, and cooling of the ambient interstellar medium (ISM) in large-scale flows powered by OB cluster feedback can drive the production of dense molecular clouds. We review the current state of the field, with a strong focus on the explicit modelling and observation of the neutral ISM. Magnetohydrodynamic simulations of colliding ISM flows provide a strong theoretical framework in which to view feedback-driven cloud formation, as do models of the gravitational fragmentation of expanding shells. Rapid theoretical developments are accompanied by a growing body of observational work that provides good evidence for the formation of molecular gas via stellar feedback—both in the Milky Way and the Large Magellanic Cloud. The importance of stellar feedback compared with other major astrophysical drivers of dense gas formation remains to be investigated further, and will be an important target for future work.