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Veterans are at high risk for suicide; emotion dysregulation may confer additional risk. Dialectical behaviour therapy (DBT) is a well-supported intervention for suicide attempt reduction in individuals with emotion dysregulation, but is complex and multi-component. The skills group component of DBT (DBT-SG) has been associated with reduced suicidal ideation and emotion dysregulation. DBT-SG for Veterans at risk for suicide has not been studied.
This study sought to evaluate the feasibility and acceptability of DBT-SG in Veterans and to gather preliminary evidence for its efficacy in reducing suicidal ideation and emotion dysregulation and increasing coping skills.
Veterans with suicidal ideation and emotion dysregulation (N = 17) enrolled in an uncontrolled pilot study of a 26-week DBT-SG as an adjunct to mental health care-as-usual.
Veterans attended an average 66% of DBT-SG sessions. Both Veterans and their primary mental health providers believed DBT-SG promoted Veterans’ use of coping skills to reduce suicide risk, and they were satisfied with the treatment. Paired sample t-tests comparing baseline scores with later scores indicated suicidal ideation and emotion dysregulation decreased at post-treatment (d = 1.88, 2.75, respectively) and stayed reduced at 3-month follow-up (d = 2.08, 2.59, respectively). Likewise, skillful coping increased at post-treatment (d = 0.85) and was maintained at follow-up (d = 0.91).
An uncontrolled pilot study indicated DBT-SG was feasible, acceptable, and demonstrated potential efficacy in reducing suicidal ideation and emotion dysregulation among Veterans. A randomized controlled study of DBT-SG with Veterans at risk for suicide is warranted.
This paper investigates the development process of emergent materials for architecture by looking at the example of Phase Change Materials. In the context of the complex nature of the constructed environment and the functional and performance requirements for buildings, emergent materials have to be carefully tuned for maximum performance. Investigating the relationship of time, space and matter in the design and development process through interdisciplinary endeavors is at the heart of this investigation. Furthermore, a shift from multidisciplinary endeavors to truly interdisciplinary collaboration that crosses the traditional boundaries of the individual fields is suggested.
Long-term in situ soil and water conservation experiments are rare in sub-Saharan Africa, particularly in Eastern Africa. A long-term experiment was conducted (2005–2013) on a Vertisol to quantify the impacts of resource-conserving agriculture (RCA) on runoff, soil loss, soil fertility and crop productivity and economic profitability in northern Ethiopia. Two RCA practices were developed from traditional furrow tillage practices: (i) derdero+ (DER+) and terwah+ (TER+). DER+ is a furrow and permanent raised bed planting system, tilled once at planting time by refreshing the furrow and 30% of crop residue is retained. TER+ is ploughed once at planting, furrows are made at 1.5 m intervals and 30% crop residue is retained. The third treatment was a conventional tillage (CT) with a minimum of three tillage operations and complete removal of crop residues. Wheat, teff, barley and grass pea crops were grown in rotation. Runoff, and soil and nutrient loss were measured in plastic sheet-lined collector trenches. Significantly different (P < 0.05) runoff coefficients (%) and soil losses (t ha−1) averaged over 9 yrs were 14 and 3, 22 and 11 and 30 and 17 for DER+, TER+ and CT, respectively. Significant improvements in crop yield and gross margin were observed after a period of three years of cropping This study demonstrated that RCA systems in semi-arid agro-ecosystems constitute a field rainwater conservation and soil fertility improvement strategy that enhances crop productivity and economic profitability. Adoption of RCA systems (DER+ and TER+) in the study area requires further work to improve smallholder farmers’ awareness on benefits, to guarantee high standards during implementation and to design appropriate weed management strategies.
Introduction: Digoxin or propranolol are used as first-line enteral agents for treatment of infant supraventricular tachycardia. We used a large national database to determine whether enteral digoxin or propranolol was more effciacious as first-line infant supraventricular tachycardia therapy. Materials and Methods: The Pediatric Health Information System database was queried over 10 years for infants with supraventricular tachycardia initiated on enteral digoxin or propranolol monotherapy. Patients were excluded for Wolff–Parkinson–White, intravenous antiarrhythmics (other than adenosine), or death. Success was considered as discharge on the initiated monotherapy. Risk factors for successful monotherapy and risk factors for readmission for supraventricular tachycardia for patients discharged on monotherapy were determined. Results: A total of 374 patients (59.6% male) met the study criteria. Median length of stay was 7 days (interquartile range of 3–16 days). Patients had CHD (n=199, 53.2%) and underwent cardiac surgery (n=123, 32.9%), ICU admission (n=238, 63.6%), mechanical ventilation (n=146, 39.0%), and extracorporeal membrane oxygenation (n=3, 0.8%). Pharmacotherapy initiation was at median 37 days of life (interquartile range of 12–127 days) and 47.3% were initiated on digoxin. Success was similar between digoxin (73.1%) and propranolol (73.5%). Initial therapy with digoxin was not associated with success (odds ratio 1.01, 95% CI 0.64–1.61, p=0.93). Multivariable analysis demonstrated hospital length of stay (odds ratio 0.98, 95% CI 0.98–1.00) and involvement of a paediatric cardiologist (odds ratio 0.46, 95% CI 0.29–0.75) associated with monotherapy failure, and male gender (odds ratio 1.66, 95% CI 1.03–2.67) associated with monotherapy success. No variables were significant for readmission on multivariable analysis. Discussion: Digoxin or propranolol may be equally efficacious for inpatient treatment of infant supraventricular tachycardia.
The late Maastrichtian to Late Paleocene seismostratigraphic record of the Roer Valley Graben provides new data on the timing and dynamics of stress changes related to the intra-plate deformation of northwestern Europe. During the deposition of late Maastrichtian to middle Danian limestones, no severe tectonic movements occurred in the southern part of the Roer Valley Graben. Around the late Danian, a known fundamental change in the European intra-plate stress field initiated an increase in subsidence of the southern part of the Roer Valley Graben. Subsidence along the graben border zone enabled relatively thick accumulations of the latest Danian to mid-Selandian siliciclastics in the intra-graben zone. Subsidence was not bounded by large offsets along faults, but rather by flexuring within and along the borders of the Roer Valley Graben. The intensity of these dynamics diminished after the middle Selandian. Most likely due to inherited intra-basinal structural differences, the northern and southern part of the Roer Valley Graben experienced distinctly different late Maastrichtian to Late Paleocene tectonics.
Background: Few measures exist to examine therapist empathy as it occurs in session. Aims: A 9-item observer rating scale, called the Therapist Empathy Scale (TES), was developed based on Watson's (1999) work to assess affective, cognitive, attitudinal, and attunement aspects of therapist empathy. The aim of this study was to evaluate the inter-rater reliability, internal consistency, and construct and criterion validity of the TES. Method: Raters evaluated therapist empathy in 315 client sessions conducted by 91 therapists, using data from a multi-site therapist training trial (Martino et al., 2010) in Motivational Interviewing (MI). Results: Inter-rater reliability (ICC = .87 to .91) and internal consistency (Cronbach's alpha = .94) were high. Confirmatory factor analyses indicated some support for single-factor fit. Convergent validity was supported by correlations between TES scores and MI fundamental adherence (r range .50 to .67) and competence scores (r range .56 to .69). Discriminant validity was indicated by negative or nonsignificant correlations between TES and MI-inconsistent behavior (r range .05 to −.33). Conclusions: The TES demonstrates excellent inter-rater reliability and internal consistency. Results indicate some support for a single-factor solution and convergent and discriminant validity. Future studies should examine the use of the TES to evaluate therapist empathy in different psychotherapy approaches and to determine the impact of therapist empathy on client outcome.
The negative effect of invasive species on native species, communities, and ecosystems is widely recognized, and the economic effects in the United States are estimated to be billions of dollars annually. Studies often examine traits of nonnative species or examine what makes a particular habitat invasible. To better understand the factors governing invasions, we used the flora of Nebraska to characterize and compare native and nonnative plant occurrences throughout the state. In addition, we assessed four critical landscape predictors of nonnative plant richness: human population size and three land cover attributes that included percentage of grassland, percentage of agriculture, and percentage of public lands. Results indicated that individual plant species richness has increased by about 35% through invasions (primarily of annuals from the family Poaceae). In addition, human population density, percentage of agriculture, and percentage of public lands all show a positive association with nonnative plant richness. Successful plant invasions may change the composition of species communities, basic ecological functions, and the delivery of ecosystem services. Thus, identifying the factors that influence such variation in distribution patterns can be fundamental to recognizing the present and potential future extent of nonnative plant infestations and, in turn, developing appropriate management programs.
Young people with self-experienced cognitive thought and perception deficits (basic symptoms) may present with an early initial prodromal state (EIPS) of psychosis in which most of the disability and neurobiological deficits of schizophrenia have not yet occurred.
To investigate the effects of an integrated psychological intervention (IPI), combining individual cognitive–behavioural therapy, group skills training, cognitive remediation and multifamily psychoeducation, on the prevention of psychosis in the EIPS.
A randomised controlled, multicentre, parallel group trial of 12 months of IPI v. supportive counselling (trial registration number: NCT00204087). Primary outcome was progression to psychosis at 12- and 24-month follow-up.
A total of 128 help-seeking out-patients in an EIPS were randomised. Integrated psychological intervention was superior to supportive counselling in preventing progression to psychosis at 12-month follow-up (3.2% v. 16.9%; P = 0.008) and at 24-month follow-up (6.3% v. 20.0%; P = 0.019).
Integrated psychological intervention appears effective in delaying the onset of psychosis over a 24-month time period in people in an EIPS.
To capitilize on the special advantages of gyrotron radiation for fast and continuous materials processing, surface and interface layers are ‘alloyed’ with lossy chemicals and fine-disperse powders. The principles and practical uses are described herein.
We have developed an amino-functional silicone resin to toughen epoxies which, when prereacted with the epoxy function in resins, undergoes in-situ phase separation during final epoxy curing. SEM analyses of the morphology of fracture surfaces of MY720- DDS, Epon 828-DDS and other epoxy matrices modified with the silicone resin showed rough surfaces with the formation of very uniform <10 μm spheres. Silicon and sulfur elemental distribution mapping showed silicon rich spheres embedded in an epoxy matrix. We report cavitation, particle debonding and pull-out, and an increases in fracture surface area as possible modes of toughening. Silicone modified materials give improvements in slow strain rate G1c fracture toughness measurements of 250–400%, similar to carboxy terminated polybutadiene-acrylonitrile copolymer (CTBN) modifiers, but with a much smaller flexural modulus loss. The Tg of the modified epoxy matrices are maintained, moisture resistance is improved, and flammability is reduced.
We have fabricated numerous magnetometers using our high temperature superconducting (HTS) Josephson junctions. These Josephson junctions are fabricated in a superconducting-normal-superconducting ramp edge configuration1 with silver doped YBa2Cu3O7 (YBCO) for the superconducting electrodes and PrBa2Cu3O7, (PBCO) for the normal layer. Small inductance quantum interference devices (SQUEDs) made from this junction technology have a transfer function exceeding 150 microvolts per flux quanta and a flux noise of 5×10−6flux quanta per root hertz. In addition, we have established that these junctions have identical electrical characteristics after either a year of storage or repeated thermal cycling. We have also examined the trade-off of 1/f noise versus thermal noise that is obtained as we vary the critical current of the devices.
The SQUID magnetometers were made using galvanically coupled input coils. These devices exhibit excellent operational characteristics in the geomagnetic field. They functioned in an unshielded environment for more than 24 hours and operated in a moving dewar (without any feedback fields to compensate the changing applied field) - both without flux trapping. Noise characteristics under these conditions are presented.
The new songs had no humility. They pushed past the veil and opened a window into the darkness and climbed through it with a knife in their teeth . . . . They were beautiful songs, full of places and textures – flesh, velvet, concrete, city towers, desert sand, snakes, violence, wet glands, childhood, the pure wings of night insects. Anything you could think of was there, and you could move through it as if it were an endless series of rooms and passages full of visions and adventures. And even if it was about killing and dying – that was just another place to go.
mary gaitskill, veronica
While Mary Gaitskill's character Alison Owen does not refer to the Beatles in the above epigraph, the musical and lyrical range of what she deems the “new songs” owes a tremendous debt to the group from Liverpool. While some early pop artists, such as Chuck Berry, had occasionally explored topics other than puppy love, teen angst, and the exuberance of youth, serious considerations of subjects beyond this terrain fell mainly to performers in the traditional and folk genres, and few ever reached the level of “visions and adventures.” Indeed, had a few brave souls forayed into this uncharted territory, the audience might have taunted them off the stage. Starting with A Hard Day's Night, however, and reaching fruition in Rubber Soul and Revolver, the Beatles crossed a the matic threshold that would both inspire their pop contemporaries and develop an audience ready for songs about more than hand-holding and whispered secrets. It is no coincidence that Rubber Soul took its narrative cues more from folk crossovers such as Bob Dylan and the Byrds than from the Beatles' pop cohorts. Sonically the influences were numerous, from the soul alluded to in the album's title to country and western and Indian sitar music.
Remarkably, while critics inevitably cite Rubber Soul as the Beatles' “transitional” album, the shift from successful pop act to unparalleled masters of the studio took but three years. Ultimately, the demarcation between Beatlemania and the studio years proves an arbitrary one, for from the beginning the Beatles, especially John Lennon, showed a lyrical uneasiness with their expected subject matter.
Public participation in natural resource management has been described as paradoxical: citizens want the best science to guide natural resource management decisions, but not to the exclusion of their input; agencies want meaningful citizen involvement in their management decisions, but they also want citizens to trust their scientific expertise. As a result, many studies have focused on developing criteria for designing successful participatory processes. Rather than definitive guidelines, however, studies to date typically indicate broad rules of thumb, which may differ in situation-specific application depending on political and historical context. These observations suggest the need to identify contextual elements that influence the varying success of participatory process designs. One such element is the degree of understanding, or coorientation, between stakeholders and managers. This article expands the concept of coorientation to “coorientation contexts” to describe the real and/or incorrectly perceived barriers and opportunities for communication between natural resource managers and stakeholders. Examining participation philosophies and corresponding techniques reveals that certain types of communication are better suited to certain coorientation contexts. Tailoring participation strategies to the appropriate coorientation context throughout the evolution of public issues, i.e., “matching the forum to the fuss,” may ultimately result in more informed, equitable, and sustainable management decisions. Future empirical testing of this approach may improve natural resource managers' abilities to navigate successfully the paradox of public involvement in natural resource management.
Although the importance of hedgerows for sustainable agriculture and conservation of rural biodiversity is increasingly being recognized, obtaining insight into the spatial and temporal dynamics of hedgerow networks remains an important challenge for landscape ecologists, with the key factors driving changes in rural landscape structure especially deserving further attention. The present study analyses the long-term history of a hedgerow network landscape in Flanders, Belgium. A detailed reconstruction of the hedgerow network is made at five points in time, starting at the end of the 18th century until present, for 367 distinct 400 m×400 m samples. Whilst hedgerows were mainly concentrated around historical village centres and within valleys at the end of 18th century, the network expanded progressively during the 19th century. In the 20th century, the hedgerow network degraded strongly, with hedgerow density and connectivity declining and mesh-size heterogeneity and network fragmentation increasing, although the network recovered slightly during the 1990s. Different trajectories of change in hedgerow network structure were observed depending on landscape position, with both topography and village proximity significantly affecting hedgerow network dynamics. The present network structure was mainly governed by land use, with highly developed networks being predominantly associated with pasture. Three main conclusions arise from the results of this study. First, the role of land use and landscape position as basic factors steering hedgerow network dynamics at the landscape scale is demonstrated. Second, the long-term perspective of the study enabled insight into the poorly known expansion phase of hedgerow networks, linked mainly with the development of small-scale labour-intensive agriculture. Finally, the findings confirm the large-scale degradation of linear semi-natural habitats in European agricultural landscapes during most of the 20th century, and indicate that a pro-active rural policy can halt and even reverse this process.
As water mills are quickly disappearing throughout Turkey, it is becoming very difficult to collect information about this type of ancient technology. By means of an ethno-archaeological study carried out in the territory of ancient Sagalassos (Pisidia), the very limited remains of 15 water mills were recorded. Following the recent introduction of electric mills, water mills have lost their previous importance and today some of the mill houses are used as stables or shelters. Interviews with local people provided some information about the capacity of the mills and about the kind of grain that was ground in them. All the mills under discussion belong to the ‘ordinary’ horizontal-wheeled type of water mill. This type may have originated in or near Turkey during the Hellenistic period. A literary and archaeological study concerning the various types of mills showed that the type found near Sagalassos was best suited to local circumstances. Tax records confirm the presence of water mills in the area during early Ottoman times.