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According to cognitive behavioural theory, cognitive factors (i.e. underlying general dysfunctional beliefs and (situation) specific illness beliefs) are theorized to lead to outcomes like anxiety and depression. In clinical practice, general dysfunctional beliefs are generally not tackled directly in short-term-therapy.
The goal of the present study was to investigate the associations of general versus specific illness beliefs on anxiety and depressive symptoms and psychiatric disorders among a subgroup of patients with inflammatory bowel disease (IBD) with poor mental quality of life (QoL).
This study concerns cross-sectional data, collected at baseline from a randomized clinical trial. One hundred and eighteen patients, recruited at four Dutch hospitals, with poor QoL (score ≤23 on the mental health subscale of the Short-Form 36-item Health-Survey; SF-36) were included. General dysfunctional beliefs were measured by the Dysfunctional Attitude Scale (DAS), specific illness beliefs by the Illness Perceptions Questionnaire-Revised (IPQ-R), anxiety and depressive symptoms by the Hospital Anxiety and Depression Scale (HADS), and psychiatric disorders by the Structured Clinical Interview for DSM-IV Axis-I Disorders (SCID-I).
Univariate analyses showed associations between the level of anxiety and/or depression and general dysfunctional beliefs and four specific illness beliefs (consequences, personal control, emotional representations and treatment control). Among patients with IBD with psychiatric disorders, only the DAS was significantly associated with anxiety and depression (DAS added to IPQ-R and IPQ-R added to DAS).
Psychological interventions may have to target general dysfunctional beliefs of patients with IBD with co-morbid psychiatric disorders to be effective. These patients with IBD are especially in need of psychological treatment.
We have explored the merits of using a Hgl2 spectrometer as a detector in x-ray diffraction systems instead of a proportional gas counter, or a scintillation counter. The full width at half maximum energy resolution of the HgI2 spectrometer used was about 1.1 keV for the CuKα line (8.1 keV), and about 1.5 keV for the MoKα line (17.4 keV), The energy resolution was utilised to eliminate x-ray fluorescence background from powder diffraction spectra. We demonstrate the suppression of Fe x-ray fluorescence in diffraction patterns of ErFe03 obtained with a Cu x-ray tube, and of Y x-ray fluorescence in diffraction patterns of Y2O3 obtained with a Mo x-ray tube. The peak height to background ratios were improved by about an order of magnitude in both cases.
As depression has a recurrent course, relapse and recurrence prevention is essential.
In our randomised controlled trial (registered with the Nederlands trial register, identifier: NTR1907), we found that adding preventive cognitive therapy (PCT) to maintenance antidepressants (PCT+AD) yielded substantial protective effects versus antidepressants only in individuals with recurrent depression. Antidepressants were not superior to PCT while tapering antidepressants (PCT/−AD). To inform decision-makers on treatment allocation, we present the corresponding cost-effectiveness, cost-utility and budget impact.
Data were analysed (n = 289) using a societal perspective with 24-months of follow-up, with depression-free days and quality-adjusted life years (QALYs) as health outcomes. Incremental cost-effectiveness ratios were calculated and cost-effectiveness planes and cost-effectiveness acceptability curves were derived to provide information about cost-effectiveness. The budget impact was examined with a health economic simulation model.
Mean total costs over 24 months were €6814, €10 264 and €13 282 for AD+PCT, antidepressants only and PCT/−AD, respectively. Compared with antidepressants only, PCT+AD resulted in significant improvements in depression-free days but not QALYs. Health gains did not significantly favour antidepressants only versus PCT/−AD. High probabilities were found that PCT+AD versus antidepressants only and antidepressants only versus PCT/−AD were dominant with low willingness-to-pay thresholds. The budget impact analysis showed decreased societal costs for PCT+AD versus antidepressants only and for antidepressants only versus PCT/−AD.
Adding PCT to antidepressants is cost-effective over 24 months and PCT with guided tapering of antidepressants in long-term users might result in extra costs. Future studies examining costs and effects of antidepressants versus psychological interventions over a longer period may identify a break-even point where PCT/−AD will become cost-effective.
Declaration of interest
C.L.H.B. is co-editor of PLOS One and receives no honorarium for this role. She is also co-developer of the Dutch multidisciplinary clinical guideline for anxiety and depression, for which she receives no remuneration. She is a member of the scientific advisory board of the National Insure Institute, for which she receives an honorarium, although this role has no direct relation to this study. C.L.H.B. has presented keynote addresses at conferences, such as the European Psychiatry Association and the European Conference Association, for which she sometimes receives an honorarium. She has presented clinical training workshops, some including a fee. She receives royalties from her books and co-edited books and she developed preventive cognitive therapy on the basis of the cognitive model of A. T. Beck. W.A.N. has received grants from the Netherlands Organisation for Health Research and Development and the European Union and honoraria and speakers' fees from Lundbeck and Aristo Pharma, and has served as a consultant for Daleco Pharma.
When analysing the fermentative breakdown of cell wall material in plants it is important to realize that it is not homogeneous. The cell walls are composed of different cell wall types which can differ in both their breakdown characteristics and composition. In this experiment in vitro cumulative gas production (Theodorou et al., 1994) was measured to study breakdown characteristics of cell walls from hulls and endosperm of soya beans.
Electroconvulsive therapy (ECT) is one of the most effective treatments for severe depression. However, little is known regarding brain functional processes mediating ECT effects.
In a non-randomized prospective study, functional magnetic resonance imaging data during the automatic processing of subliminally presented emotional faces were obtained twice, about 6 weeks apart, in patients with major depressive disorder (MDD) before and after treatment with ECT (ECT, n = 24). Additionally, a control sample of MDD patients treated solely with pharmacotherapy (MED, n = 23) and a healthy control sample (HC, n = 22) were obtained.
Before therapy, both patient groups equally showed elevated amygdala reactivity to sad faces compared with HC. After treatment, a decrease in amygdala activity to negative stimuli was discerned in both patient samples indicating a normalization of amygdala function, suggesting mechanisms potentially unspecific for ECT. Moreover, a decrease in amygdala activity to sad faces was associated with symptomatic improvements in the ECT sample (rspearman = −0.48, p = 0.044), and by tendency also for the MED sample (rspearman = −0.38, p = 0.098). However, we did not find any significant association between pre-treatment amygdala function to emotional stimuli and individual symptom improvement, neither for the ECT sample, nor for the MED sample.
In sum, the present study provides first results regarding functional changes in emotion processing due to ECT treatment using a longitudinal design, thus validating and extending our knowledge gained from previous treatment studies. A limitation was that ECT patients received concurrent medication treatment.
The authors discuss results of long-term Dutch field projects in three regions in Italy and review case studies taken from these study areas in the light of indigenous developments in early Italian centralization and urbanization. By looking at regional developments in the domains of economy, religious and funerary practice as well as that of social relationships, they arrive at the conclusion that material culture was actively used in indigenous contexts. There is a consequent need for re-definition of centralization and urbanization, which in the Italian context are often seen as non-indigenous achievements. Comparative regional research, as suggested by the authors' case studies on the Sibaritide, the Brindisino and the Pontine region, will reveal both general trends concerning the concepts discussed and regional idiosyncrasies depending on regional traditions, histories and the regional landscape. To this end, a new project was launched, known as the Regional Pathways to Complexity project, that is introduced to the reader at the end of this paper.
We present our first results of a photometric monitoring project of the twin quasar 0957+561. This project aims mainly at the improvement of the determination of the time delay ΔT(A,B) for this gravitational lens, since the “time delay controversy on QSO 0957+561 (is) not yet decided” (Pelt et al. 1994). In addition, the quite large field of the CCD used allows also a long-term astrometric and photometric study of stars and galaxies in the field within a radius of about 10 arcminutes around the lens.
The Utrecht Orbiting Ultraviolet Stellar Spectrophotometer S59 on board the ESRO TD-1A satellite has observed ultraviolet spectra of about 200 stars in the wavelength regions 2060–2160 Å. 2490–2590 Å and 2770–2870 Å with a resolution of 1.8 Å (cf. de Jager et al., 1974). The spectra are analyzed in order to find UV criteria for stellar classification. Particular attention has been given to Fe III lines since no strong lines of this ion occur in the visible part of the spectrum. As one of the most striking results, it is found that the feature at 2078 Å, which is mainly due to Fe III, is very sensitive to luminosity.
Current ultra-high-risk (UHR) criteria appear insufficient to predict imminent onset of first-episode psychosis, as a meta-analysis showed that about 20% of patients have a psychotic outcome after 2 years. Therefore, we aimed to develop a stage-dependent predictive model in UHR individuals who were seeking help for co-morbid disorders.
Baseline data on symptomatology, and environmental and psychological factors of 185 UHR patients (aged 14–35 years) participating in the Dutch Early Detection and Intervention Evaluation study were analysed with Cox proportional hazard analyses.
At 18 months, the overall transition rate was 17.3%. The final predictor model included five variables: observed blunted affect [hazard ratio (HR) 3.39, 95% confidence interval (CI) 1.56–7.35, p < 0.001], subjective complaints of impaired motor function (HR 5.88, 95% CI 1.21–6.10, p = 0.02), beliefs about social marginalization (HR 2.76, 95% CI 1.14–6.72, p = 0.03), decline in social functioning (HR 1.10, 95% CI 1.01–1.17, p = 0.03), and distress associated with suspiciousness (HR 1.02, 95% CI 1.00–1.03, p = 0.01). The positive predictive value of the model was 80.0%. The resulting prognostic index stratified the general risk into three risk classes with significantly different survival curves. In the highest risk class, transition to psychosis emerged on average ⩾8 months earlier than in the lowest risk class.
Predicting a first-episode psychosis in help-seeking UHR patients was improved using a stage-dependent prognostic model including negative psychotic symptoms (observed flattened affect, subjective impaired motor functioning), impaired social functioning and distress associated with suspiciousness. Treatment intensity may be stratified and personalized using the risk stratification.
We present preliminary results of models of terrestrial planet formation using on the one hand classical numerical integration of hundreds of small bodies on CPUs and on the other hand—for comparison—the results of our GPU code with thousands of small bodies which then merge to larger ones. To be able to determine the outcome of collision events we use our smooth particle hydrodynamics (SPH) code which tracks how water is lost during such events.
The Be X-ray binaries show rather weak and variable X-rays. They can be divided into two types, the transient sources and the permanent sources. Two ranges for the X-ray luminosity Lx can be discerned: a) Lx~1034erg s−1 (X Per, λ Cas, 2S0114+65, all permanent sources); b) Lx~1036erg s−1. They have long periods, hence wide orbits, they ar not eclipsing and their mass loss rates are low. The optical spectra are generally very variable and irregular, masking periodic changes. No optical orbits exist and only for 4U0115+63 an X-ray orbit is known (Rappaport et al.1978). An overview of the Be X-ray binaries with some of their characteristics is given in Table 1.
A cosmic ray detector, sensitive to γ-Rays with energies greater than 500 MeV is being flown on board the OGO-5 satellite. The spacecraft was launched into a highly eccentric orbit, apogee 145000 km, on March 4, 1968. γ-Ray observations are restricted to altitudes higher than 80000 km, thereby excluding interference from the radiation belts and reducing the influence from the earth albedo flux. A description of the instrument is published in the literature (Rogowski et al., 1969).
Background: Hypospadias is associated with twinning. The incidence of hypospadias in monochorionic and dichorionic male twins is, however, yet to be determined. Methods: All medical records of monochorionic and dichorionic twins admitted to our neonatal nursery between January 2004 and August 2013 were reviewed for the presence of hypospadias. Results: A total of 350 monochorionic and 303 dichorionic male twins were included in the study. The incidence of hypospadias in monochorionic and dichorionic groups was 4% (14/350) and 1% (3/303) (p = .016) respectively. In 11 of the 15 twin couples, hypospadias occurred in the twin with the lowest birth weight. The rate of hypospadias in twin infants small-for-gestational-age group was 10% (6/60) compared with 2% (11/593) in the appropriate-for-gestational-age group (p = .002). In a multivariate analysis, both monochorionicity and small-for-gestational-age were independently associated with hypospadias, odds ratio 4.1 (95% confidence interval (CI): 1.1–14.7) and 6.1 (95% CI: 2.2–17.2) respectively. Conclusions: The incidence of hypospadias is four-fold higher in monochorionic twins compared with dichorionic twins. Hypospadias is also independently associated with small-for-gestational-age.
We investigated the Quaternary lithological succession and faunas in a borehole near Moriaanshoofd (Province of Zeeland, SW Netherlands), in order to improve our understanding of the depositional context of classical Gelasian mammal faunas from the region. The fossils mostly derive from the base of a fossil-rich interval between 31 m and 36.5 m below the surface, that was initially interpreted as a Middle or Late Pleistocene interglacial marine unit, but turned out to be a Late Quaternary fluvial unit with large amounts of reworked fossils and sediments. Eocene mollusc taxa pinpoint Flanders (Belgium) as the source region for this river. Within the base of this paleo-Schelde River fossil material of various stratigraphic provenance became incorporated.
To characterise auditory involvement secondary to excessive craniotubular bone growth in individuals with sclerosteosis in South Africa.
This cross-sectional study assessed the auditory profile of 10 participants with sclerosteosis. An auditory test battery was used and results for each ear were recorded using descriptive and comparative analyses.
All participants presented with bilateral, mixed hearing losses. Of the 20 ears, hearing loss was moderate in 5 per cent (n = 1), severe in 55 per cent (n = 11) and profound in 40 per cent (n = 8). Air–bone gaps were smaller in older participants, although the difference was not statistically significant (p > 0.05). Computed tomography scans indicated pervasive abnormalities of the external auditory canal, tympanic membrane, middle-ear space, ossicles, oval window, round window and internal auditory canal. Narrowed internal auditory canals corresponded to poor speech discrimination, indicative of retrocochlear pathology and absent auditory brainstem response waves.
Progressive abnormal bone formation in sclerosteosis involves the middle ear, the round and oval windows of the cochlea, and the internal auditory canal. The condition compromises conductive, sensory and neural auditory pathways, which results in moderate to profound, mixed hearing loss.
High resolution Schottky barrier detectors for alpha particles have been fabricated on 20 μm n-type 4H-SiC epitaxial layers. Schottky barrier contact structure was accomplished by deposition of 10 nm nickel on the Si face of the epilayers. The detectors were characterized for structural, electrical, and spectroscopic properties. Scanning electron microscopy and Nomarski optical microscopy revealed a micropipe density lower than 1 cm-2. The current-voltage (I-V) characteristics of the device exhibited very low leakage current of the order of 6.5 pA at an operating bias of 90 V. C-V measurements revealed a typical effective doping concentrations of 2.4 × 1014 cm-3 in these epilayers. The detectors were evaluated for alpha particles detection using a 241Am source. An energy resolution of ∼0.98% for 5.48 MeV alpha particles was observed. The separate contribution of charge carrier drift and diffusion to the total charge collection efficiency has been calculated in these detectors following a drift-diffusion model. Detailed electronic noise analysis in terms of equivalent noise charge (ENC) was carried out to study the effect of various noise components that contribute to the total electronic noise in the detection system. Effect of shaping time, presence of source and bias on the ENC has been studied in details.
Cd0.9Zn0.1Te (CZT) single crystal has been grown using a tellurium solvent method. Two CZT crystals have been chosen from two different locations of the grown ingot. The two crystals were characterized using infrared transmission (IR) imaging and radiation detectors in planar geometry were fabricated on them. Current-voltage characteristics (I-V) revealed a resistivity of ∼8.6×1010 Ω−cm for detector A (6.9×6.9×4.8 mm3) and 6.7×1010 Ω−cm for detector B (11.5×11.7×2.6 mm3). IR imaging showed a lesser concentration of Te inclusions/precipitates in detector A. The transport properties viz., electron drift-mobility and electron mobility-lifetime product were measured using alpha spectroscopy in these detectors in a planar configuration. Detector A showed better charge transport properties compared to detector B. The superior transport properties of crystal A were reflected in the spectroscopic properties of the detectors. Gamma pulse height measurements using a 241Am isotope revealed an energy resolution of ∼5 % for detector A and ∼7 % for detector B. A digital spectrometer and a biparametric correction scheme was incorporated to recover the pulse height spectrum of high energy gamma rays (137Cs source) from the effect of poor hole movement.