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Systematic reviews and meta-analyses suggest that behaviour change interventions have modest effect sizes, struggle to demonstrate effect in the long term and that there is high heterogeneity between studies. Such interventions take huge effort to design and run for relatively small returns in terms of changes to behaviour.
So why do behaviour change interventions not work and how can we make them more effective? This article offers some ideas about what may underpin the failure of behaviour change interventions. We propose three main reasons that may explain why our current methods of conducting behaviour change interventions struggle to achieve the changes we expect: 1) our current model for testing the efficacy or effectiveness of interventions tends to a mean effect size. This ignores individual differences in response to interventions; 2) our interventions tend to assume that everyone values health in the way we do as health professionals; and 3) the great majority of our interventions focus on addressing cognitions as mechanisms of change. We appeal to people’s logic and rationality rather than recognising that much of what we do and how we behave, including our health behaviours, is governed as much by how we feel and how engaged we are emotionally as it is with what we plan and intend to do.
Drawing on our team’s experience of developing multiple interventions to promote and support health behaviour change with a variety of populations in different global contexts, this article explores strategies with potential to address these issues.
Although behavior therapy reduces tic severity, it is unknown whether it improves co-occurring psychiatric symptoms and functional outcomes for adults with Tourette's disorder (TD). This information is essential for effective treatment planning. This study examined the effects of behavior therapy on psychiatric symptoms and functional outcomes in older adolescents and adults with TD.
A total of 122 individuals with TD or a chronic tic disorder participated in a clinical trial comparing behavior therapy to psychoeducation and supportive therapy. At baseline, posttreatment, and follow-up visits, participants completed assessments of tic severity, co-occurring symptoms (inattention, impulsiveness, hyperactivity, anger, anxiety, depression, obsessions, and compulsions), and psychosocial functioning. We compared changes in tic severity, psychiatric symptoms, and functional outcomes using repeated measure and one-way analysis of variance.
At posttreatment, participants receiving behavior therapy reported greater reductions in obsessions compared to participants in supportive therapy (
$\eta _p^2 $
= 0.04, p = 0.04). Across treatments, a positive treatment response on the Clinical Global Impression of Improvement scale was associated with a reduced disruption in family life (
$\eta _p^2 $
= 0.05, p = 0.02) and improved functioning in a parental role (
$\eta _p^2 $
= 0.37, p = 0.02). Participants who responded positively to eight sessions of behavior therapy had an improvement in tic severity (
$\eta _p^2 $
= 0.75, p < 0.001), inattention (
$\eta _p^2 $
= 0.48, p < 0.02), and functioning (
$\eta _p^2 $
= 0.39–0.42, p < 0.03–0.04) at the 6-month follow-up.
Behavior therapy has a therapeutic benefit for co-occurring obsessive symptoms in the short-term, and reduces tic severity and disability in adults with TD over time. Additional treatments may be necessary to address co-occurring symptoms and improve functional outcomes.
The cold, dry, and stable air above the summits of the Antarctic plateau provides the best ground-based observing conditions from optical to sub-millimetre wavelengths to be found on the Earth. Pathfinder for an International Large Optical Telescope (PILOT) is a proposed 2 m telescope, to be built at Dome C in Antarctica, able to exploit these conditions for conducting astronomy at optical and infrared wavelengths. While PILOT is intended as a pathfinder towards the construction of future grand-design facilities, it will also be able to undertake a range of fundamental science investigations in its own right. This paper provides the performance specifications for PILOT, including its instrumentation. It then describes the kinds of projects that it could best conduct. These range from planetary science to the search for other solar systems, from star formation within the Galaxy to the star formation history of the Universe, and from gravitational lensing caused by exo-planets to that produced by the cosmic web of dark matter. PILOT would be particularly powerful for wide-field imaging at infrared wavelengths, achieving near diffraction-limited performance with simple tip–tilt wavefront correction. PILOT would also be capable of near diffraction-limited performance in the optical wavebands, as well be able to open new wavebands for regular ground-based observation, in the mid-IR from 17 to 40 μm and in the sub-millimetre at 200 μm.
The need to manage psychological symptoms after disasters can result in an increase in the prescription of psychotropic drugs, including antidepressants and anxiolytics. Therefore, an increase in the prescription of antidepressants and anxiolytics could be an indicator of general psychological distress in the community.
The purpose of this study was to determine if there was a change in the rate of prescription of antidepressant and anxiolytic drugs following Cyclone Yasi.
A quantitative evaluation of new prescriptions of antidepressants and anxiolytics was conducted. The total number of new prescriptions for these drugs was calculated for the period six months after the cyclone and compared with the same six month period in the preceding year. Two control drugs were also included to rule out changes in the general rate of drug prescription in the affected communities.
After Cyclone Yasi, there was an increase in the prescription of antidepressant drugs across all age and gender groups in the affected communities except for males 14-54 years of age. The prescription of anxiolytic drugs decreased immediately after the cyclone, but increased by the end of the six-month post-cyclone period. Control drug prescription did not change.
There was a quantifiable increase in the prescription of antidepressant drugs following Cyclone Yasi that may indicate an increase in psychosocial distress in the community.
UsherK, BrownLH, BuettnerP, GlassB, BoonH, WestC, GrassoJ, Chamberlain-SalaunJ, WoodsC. Rate of Prescription of Antidepressant and Anxiolytic Drugs after Cyclone Yasi in North Queensland. Prehosp Disaster Med. 2012;27(6):1-5.
When is garbage not garbage? A conference on cleaning, clearing, and
reclaiming a dump site may seem an unlikely place for political scientists
and scholars of international relations to pursue professional
development, but the pursuit of knowledge knows no bounds—even if
the smell can be hard on the nose itself! Observing such supposedly
non-political sessions can quickly reveal that they are anything but, and
discussions of how garbage is handled elsewhere can offer useful
comparative insights as the local becomes global. Furthermore, few
occasions provide such a useful context for developing one's critical
thinking skills and recognizing the value of interdisciplinarity—an
approach often touted as desirable in our profession.My thanks to John Chilton, Jeremy Bendik-Keymer, the members
of the Dubai Natural History Group, and an anonymous reviewer for this
journal for their feedback on earlier versions of this essay. I am also
indebted to Hassan Tayim, Robert Cook, and the participants in the
conference which prompted this article for their organizational efforts
Vapor transport deposition is being developed for high-rate synthesis of CdTe thin films. Films have been deposited at rates in excess of 20 μm/min. Thegrowth ratedependenceon source temperature yielded an apparent activation energy of 42 kcal/mol, in good agreement with the theoretical value for CdTe sublimation (45.7 kcal/mol). For substrate temperatures greater than 400°C the rate limiting step was resublimation. This phenomenon had a dramatic influence on morphology, although x-ray diffraction of all films indicated a strong (111) orientation. A preliminary device optimization investigating the effect of CdTe deposition temperature, post-deposition CdCl2 anneal parameters, alternative back contacts, and high-resistance buffer layers yielded a best cell with efficiency of 9.8% (704 mV Voc, 21.0mA/cm2 Jsc, 66% FF).
Plasma-enhanced chemical vapor deposition (PECVD) is being developed as a flexible coating technology for a variety of oxides. In this paper we discuss the synthesis of transparent conducting oxides (TCOs), insulating oxides and electrochromic oxides. Tin oxide was synthesized using mixtures of SnCl4 and O2. By proper control of processing conditions the resistivity of this material may be varied from 10-3 < ρ < 105 Ω-cm. Films of varying resistivity were employed as buffer layers in CdS/CdTe solar cells. Preliminary device results have demonstrated that integration of a tin oxide buffer layer was very beneficial for cell performance. In addition, we demonstrate the PECVD synthesis of WO3 from WF6/O2/H2/Ar mixtures. The plasma process space that yielded adherent, transparent tungsten oxide was established. The deposited films were both amorphous and reversibly electrochromic. High temperature annealing above 400°C converted the films into a polycrystalline state.
Atmospheric pressure chemical vapor deposition (APCVD) is being studied as an alternative for large-area manufacturing of CdTe thin films. High efficiency research cells have been constructed, but the fundamental materials properties and limitations have not been fully explored. APCVD material is examined with several techniques and compared with close-space sublimation (CSS). Transmission and scanning electron microscopy studies show a similar morphology to CSS CdTe. However high resolution TEM scans show the formation of a disordered layer between the CdTe and CdS, and the removal of defects within some grain structures upon annealing. Cathodoluminescence shows electronic defect states localized to grain boundaries. A large concentration of trap states was also observed with deep-level transient spectroscopy that may correspond to hole traps found in lower amounts in other materials. The presence of traps was also indicated in impedance spectroscopy measurements. The latter studies indicate a high grain boundary resistance contributes to transport.
Observations were made of the behaviour of a home-range group of Scottish Blackface ewes. The group, including replacement ewe lambs, remained on the hill throughout winter and was offered supplemental feedblocks from December to April. Sheep were individually identified and data collected on ranging behaviour between 06.00 and 18.00 h GMT in autumn and winter. Additionally in winter, records were made of time spent eating from the feedblock or standing within 3 m of it.
Age was found to have a strong effect on time spent eating from the feedblock, with older ewes (4 years and over) eating more than younger animals. This was partly attributable to the ewe lambs forming peer groups in winter that were uninfluenced by the movements of mature ewes to the feedblock. Consequently, the majority (0·82) of ewe lambs did not eat feedblock in their first winter. Two- and 3-year-old ewes, although not eating significantly more often from the feedblock than ewe lambs, spent significantly more time standing within 3 m of it and were prevented from eating from it by the competitive behaviour of older ewes. The increased gregariousness of hill sheep in winter appears to be an important factor in preventing the younger ewes taking advantage of the continuous availability of feedblocks. The feedblocks were also found to reduce significantly the size of ewes' home ranges.
The results indicate that the social behaviour of hill sheep limits the use of feedblocks to the older and stronger animals in the group. In addition, feedblocks may reduce the utilization by sheep of available winter forage. Alternative strategies for more effective deployment of feedblocks are discussed.
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