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Our aim was to develop a brief cognitive behavioural therapy (CBT) protocol to augment treatment for social anxiety disorder (SAD). This protocol focused specifically upon fear of positive evaluation (FPE). To our knowledge, this is the first protocol that has been designed to systematically target FPE.
To test the feasibility of a brief (two-session) CBT protocol for FPE and report proof-of-principle data in the form of effect sizes.
Seven patients with a principal diagnosis of SAD were recruited to participate. Following a pre-treatment assessment, patients were randomized to either (a) an immediate CBT condition (n = 3), or (b) a comparable wait-list (WL) period (2 weeks; n = 4). Two WL patients also completed the CBT protocol following the WL period (delayed CBT condition). Patients completed follow-up assessments 1 week after completing the protocol.
A total of five patients completed the brief, FPE-specific CBT protocol (two of the seven patients were wait-listed only and did not complete delayed CBT). All five patients completed the protocol and provided 1-week follow-up data. CBT patients demonstrated large reductions in FPE-related concerns as well as overall social anxiety symptoms, whereas WL patients demonstrated an increase in FPE-related concerns.
Our brief FPE-specific CBT protocol is feasible to use and was associated with large FPE-specific and social anxiety symptom reductions. To our knowledge, this is the first treatment report that has focused on systematic treatment of FPE in patients with SAD. Our protocol warrants further controlled evaluation.
A national need is to prepare for and respond to accidental or intentional disasters categorized as chemical, biological, radiological, nuclear, or explosive (CBRNE). These incidents require specific subject-matter expertise, yet have commonalities. We identify 7 core elements comprising CBRNE science that require integration for effective preparedness planning and public health and medical response and recovery. These core elements are (1) basic and clinical sciences, (2) modeling and systems management, (3) planning, (4) response and incident management, (5) recovery and resilience, (6) lessons learned, and (7) continuous improvement. A key feature is the ability of relevant subject matter experts to integrate information into response operations. We propose the CBRNE medical operations science support expert as a professional who (1) understands that CBRNE incidents require an integrated systems approach, (2) understands the key functions and contributions of CBRNE science practitioners, (3) helps direct strategic and tactical CBRNE planning and responses through first-hand experience, and (4) provides advice to senior decision-makers managing response activities. Recognition of both CBRNE science as a distinct competency and the establishment of the CBRNE medical operations science support expert informs the public of the enormous progress made, broadcasts opportunities for new talent, and enhances the sophistication and analytic expertise of senior managers planning for and responding to CBRNE incidents.
Examining neurometabolic abnormalities in critical brain areas in schizophrenia and major depressive disorder (MDD) may help guide future pharmacological interventions including glutamate-modulating treatments.
To measure metabolite concentrations within the anterior cingulate cortex (ACC) and thalamus of people with schizophrenia and people with MDD.
Spectra were acquired from 16 volunteers with schizophrenia, 17 with MDD and 18 healthy controls using magnetic resonance spectroscopy on a 7 Tesla scanner.
In the thalamus, there were lower glycine concentrations in the schizophrenia group relative to control (P=0.017) and MDD groups (P=0.012), and higher glutamine concentrations relative to healthy controls (P=0.009). In the thalamus and the ACC, the MDD group had lower myo-inositol concentrations than the control (P=0.014, P=0.009, respectively) and schizophrenia (P=0.004, P=0.002, respectively) groups.
These results support the glutamatergic theory of schizophrenia and indicate a potential glycine deficiency in the thalamus. In addition, reduced myo-inositol concentrations in MDD suggest its involvement in the disorder.
Recent studies suggest that sand can serve as a vehicle for exposure of humans to pathogens at beach sites, resulting in increased health risks. Sampling for microorganisms in sand should therefore be considered for inclusion in regulatory programmes aimed at protecting recreational beach users from infectious disease. Here, we review the literature on pathogen levels in beach sand, and their potential for affecting human health. In an effort to provide specific recommendations for sand sampling programmes, we outline published guidelines for beach monitoring programmes, which are currently focused exclusively on measuring microbial levels in water. We also provide background on spatial distribution and temporal characteristics of microbes in sand, as these factors influence sampling programmes. First steps toward establishing a sand sampling programme include identifying appropriate beach sites and use of initial sanitary assessments to refine site selection. A tiered approach is recommended for monitoring. This approach would include the analysis of samples from many sites for faecal indicator organisms and other conventional analytes, while testing for specific pathogens and unconventional indicators is reserved for high-risk sites. Given the diversity of microbes found in sand, studies are urgently needed to identify the most significant aetiological agent of disease and to relate microbial measurements in sand to human health risk.
On 1 December 2011 the West Antarctic Ice Sheet (WAIS) Divide ice-core project reached its final depth of 3405 m. The WAIS Divide ice core is not only the longest US ice core to date, but is also the highest-quality deep ice core, including ice from the brittle ice zone, that the US has ever recovered. The methods used at WAIS Divide to handle and log the drilled ice, the procedures used to safely retrograde the ice back to the US National Ice Core Laboratory (NICL) and the methods used to process and sample the ice at the NICL are described and discussed.
Surface enhanced Raman scattering (SERS) is a sensitive and reproducible vibrational spectroscopic technique used to detect and characterize molecules near the surface of noble metals like Au, Ag, Pt, Cu, etc. SERS enhances Raman signals through light-induced plasmonic vibrations occurring on irregular metal surfaces and localized electromagnetic augmentation. To better define nano-scale regions of the Raman signal enhancement, we generated gold nanoparticles with a unique multi-branched configuration along with surface-adsorbed fluorescent reporter molecules. The reporter molecules included a set of near-infra red active fluorescent dyes IR820 (green cyanine, photo electronic dye), DTTC (3, 3'-diethylthiatricarbocyanine iodide) and DTDC (3, 3'- diethylthiadicarbocyanine iodide). We employed a one-pot synthesis method in order to generate a stellate configuration in gold nanoparticles through the reduction of HAuCl4 with Good’s buffer, HEPES, at pH 7.4 and room temperature. A cell viability assay was performed with normal esophageal cells exposed to the multi-branched gold nanoparticles and SERS molecules to assess their toxicity. Our results demonstrate the capacity of multibranched gold nanoparticles linked to Raman reporter molecules to generate distinct signature spectra and, with the exception of the gold nanoparticles functionalized with DTTC, remain non-toxic to normal esophageal cells.
Despite the high prevalence of postnatal depression (PND), few women seek help. Internet interventions may overcome many of the barriers to PND treatment use. We report a phase II evaluation of a 12-session, modular, guided Internet behavioural activation (BA) treatment modified to address postnatal-specific concerns [Netmums Helping With Depression (NetmumsHWD)].
To assess feasibility, we measured recruitment and attrition to the trial and examined telephone session support and treatment adherence. We investigated sociodemographic and psychological predictors of treatment adherence. Effectiveness outcomes were estimated with the Edinburgh Postnatal Depression Scale (EPDS), Generalized Anxiety Disorder-7, Work and Social Adjustment Scale, Postnatal Bonding Questionnaire, and Social Provisions Scale.
A total of 249 women were recruited via a UK parenting site, Netmums.com. A total of 83 women meeting DSM-IV criteria for major depressive disorder were randomized to NetmumsHWD (n = 41) or treatment-as-usual (TAU; n = 42). Of the 83 women, 71 (86%) completed the EPDS at post-treatment, and 71% (59/83) at the 6-month follow-up. Women completed an average of eight out of 12 telephone support sessions and five out of 12 modules. Working women and those with less support completed fewer modules. There was a large effect size favouring women who received NetmumsHWD on depression, work and social impairment, and anxiety scores at post-treatment compared with women in the TAU group, and a large effect size on depression at 6 months post-treatment. There were small effect sizes for postnatal bonding and perceived social support.
A supported, modular, Internet BA programme can be feasibly delivered to postpartum women, offering promise to improve depression, anxiety and functioning.
Present and past gas-fuelling of galaxies is expected to depend upon both the properties of the galaxies themselves, as well as their larger-scale environments. In the case of galaxies in groups the environment, i.e the group mass, can be probed by measuring the velocity dispersion of the group members, as done with the GAMA Galaxy Group catalogue (Robotham et al. 2011), probing the halo mass function all the way to small groups. The gas-fuelling rate of normal late-type galaxies can be traced by the SFR under the assumption of a steady state between gas-fuelling and gas-consumption by SF. We present a method to estimate disk opacities from UV/optical photometric characteristics, calibrated using the radiative transfer model of Popescu et al. (2011), applied to UV-Opt-FIR GAMA/H-ATLAS photometry for a subset of GAMA galaxies. We use the method to extract attenuation corrected SFRs for a large sample of late-type GAMA galaxies, which we use in an initial application to constrain the dependency of star formation/gas-fuelling in late-type galaxies on mass of parent DMH, and compactness of galaxy group.
The purpose of this article is to set the context for this special issue of Disaster Medicine and Public Health Preparedness on the allocation of scarce resources in an improvised nuclear device incident. A nuclear detonation occurs when a sufficient amount of fissile material is brought suddenly together to reach critical mass and cause an explosion. Although the chance of a nuclear detonation is thought to be small, the consequences are potentially catastrophic, so planning for an effective medical response is necessary, albeit complex. A substantial nuclear detonation will result in physical effects and a great number of casualties that will require an organized medical response to save lives. With this type of incident, the demand for resources to treat casualties will far exceed what is available. To meet the goal of providing medical care (including symptomatic/palliative care) with fairness as the underlying ethical principle, planning for allocation of scarce resources among all involved sectors needs to be integrated and practiced. With thoughtful and realistic planning, the medical response in the chaotic environment may be made more effective and efficient for both victims and medical responders.
(Disaster Med Public Health Preparedness. 2011;5:S20-S31)
Healthy adolescents, and adults who engage in reward-driven, risky behaviours, demonstrate poor decision-making ability. Decision making in deliberate self-harm (DSH), a reward-driven, high-risk behaviour, has received little attention. This study assessed decision making and problem solving in adolescents with current or past SH.
Decision making and problem solving were assessed using the Iowa Gambling Task (IGT) and the Means–Ends Problem-Solving Procedure (MEPS) respectively in 133 adolescents (57 healthy and 22 depressed controls with no SH history and 54 with SH history). A second analysis separated the SH group into current (n=30) and past (n=24) SH.
The collective performance of adolescents with SH history did not differ from depressed or healthy adolescents on the IGT. However, current self-harming adolescents had a trend towards more high-risk choices (p=0.06) than those with previous SH history and were the only group not to significantly improve over time, persisting with high-risk strategy throughout. Those who no longer self-harmed learnt to use a low-risk strategy similar to healthy and depressed controls. Recency of last SH episode correlated with IGT performance. Depressed participants performed well on the IGT but poorly on the MEPS. By contrast, both collective and divided SH groups had comparable MEPS scores to healthy controls, all performing better than depressed participants.
Poor decision making is present in adolescents who currently self-harm but not in those with previous history; improvement in decision-making skills may therefore be linked to cessation of self-harm. Depressed adolescents who do and do not self-harm may have distinct characteristics.
This study tests novel methods for automatically identifying annual layers in a shallow Antarctic ice core (WDC05Q) using images that were collected with an optical scanner at the US National Ice Core Laboratory. A new method of optimized variance maximization (OVM) modeled the density-related changes in annual layer thickness directly from image variance. This was done by using multi-objective complex (MOCOM) parameter optimization to drive a low-pass filtering scheme. The OVM-derived changes in annual layer thickness corresponded well with the results of an independent glaciochemical interpretation of the core. Individual annual cycles in image brightness were then identified by using OVM results to apply a depth-varying low-pass filter and fitting a second-order polynomial to a locally detrended neighborhood. The resulting map of annual cycles agreed to within 1% of the overall annual count of the glaciochemical interpretation. Agreement on the presence of specific annual layer features was 96%. It was also shown that the MOCOM parameter optimization could calibrate the image-based results to match directly the date of a specific volcanic marker.
We show that any closed hyperbolic surface admitting a conformal automorphism with “many” fixed points is uniformly quasiconformally homogeneous, with constant uniformly bounded away from 1. In particular, there is a uniform lower bound on the quasiconformal homogeneity constant for all hyperelliptic surfaces. In addition, we introduce more restrictive notions of quasiconformal homogeneity and bound the associated quasiconformal homogeneity constants uniformly away from 1 for all hyperbolic surfaces.