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Individuals with social anxiety disorder do poorly in residential treatment programs for the treatment of drug dependence. This is not surprising given the social nature of residential rehabilitation where group work and close social interactions are required.
Given the social nature of residential rehabilitation, we were interested in exploring whether we could address social anxiety symptoms prior to treatment entry and therefore enhance the likelihood that an individual would enter treatment and stay in treatment.
To conduct a randomised control trial to evaluate whether treatment of social anxiety symptoms prior to treatment entry improves treatment entry and retention.
Treatment seeking substance users (n = 105) completed intake assessment interviews for entry into a residential rehabilitation program. Assessment comprised the Mini International Neuropsychiatric interview (Mini), the alcohol, smoking and substance involvement screening test (ASSIST), the Liebowitz Social Anxiety Scale (LSAS). Participants were randomised to either a four-session social anxiety intervention or treatment as usual (which was to remain on the waiting list until treatment entry). A survival analysis was conducted to examine whether the intervention impacted on treatment retention.
The treatment did not significantly impact on treatment but the intervention group were significantly more likely to remain in treatment and this effect was only found in women.
For individuals with social anxiety disorder brief evidence based intervention focused on ameliorating social anxiety symptoms (e.g., cognitive behavioural treatment) may improve the retention in treatment. This effect appears to be gender specific.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Knowledge of population structure and breed composition of a population can be advantageous for a number of reasons; these include designing optimal (cross)breeding strategies in order to maximise non-additive genetic effects, maintaining flockbook integrity by authenticating animals being registered and as a quality control measure in the genotyping process. The objectives of the present study were to 1) describe the population structure of 24 sheep breeds, 2) quantify the breed composition of both flockbook-recorded and crossbred animals using single nucleotide polymorphism BLUP (SNP-BLUP), and 3) quantify the accuracy of breed composition prediction from low-density genotype panels containing between 2000 and 6000 SNPs. In total, 9334 autosomal SNPs on 11 144 flockbook-recorded animals and 1172 crossbred animals were used. The population structure of all breeds was characterised by principal component analysis (PCA) as well as the pairwise breed fixation index (Fst). The total number of animals, all of which were purebred, included in the calibration population for SNP-BLUP was 2579 with the number of animals per breed ranging from 9 to 500. The remaining 9559 flockbook-recorded animals, composite breeds and crossbred animals represented the test population; three breeds were excluded from breed composition prediction. The breed composition predicted using SNP-BLUP with 9334 SNPs was considered the gold standard prediction. The pairwise breed Fst ranged from 0.040 (between the Irish Blackface and Scottish Blackface) to 0.282 (between the Border Leicester and Suffolk). Principal component analysis revealed that the Suffolk from Ireland and the Suffolk from New Zealand formed distinct, non-overlapping clusters. In contrast, the Texel from Ireland and that from New Zealand formed integrated, overlapping clusters. Composite animals such as the Belclare clustered close to its founder breeds (i.e., Finn, Galway, Lleyn and Texel). When all 9334 SNPs were used to predict breed composition, an animal that had a majority breed proportion predicted to be ≥0.90 was defined as purebred for the present study. As the panel density decreased, the predicted breed proportion threshold, used to identify animals as purebred, also decreased (≥0.85 with 6000 SNPs to ≥0.60 with 2000 SNPs). In all, results from the study suggest that breed composition for purebred and crossbred animals can be determined with SNP-BLUP using ≥5000 SNPs.
Research participants want to receive results from studies in which they participate. However, health researchers rarely share the results of their studies beyond scientific publication. Little is known about the barriers researchers face in returning study results to participants.
Using a mixed-methods design, health researchers (N = 414) from more than 40 US universities were asked about barriers to providing results to participants. Respondents were recruited from universities with Clinical and Translational Science Award programs and Prevention Research Centers.
Respondents reported the percent of their research where they experienced each of the four barriers to disseminating results to participants: logistical/methodological, financial, systems, and regulatory. A fifth barrier, investigator capacity, emerged from data analysis. Training for research faculty and staff, promotion and tenure incentives, and funding agencies supporting dissemination of results to participants were solutions offered to overcoming barriers.
Study findings add to literature on research dissemination by documenting health researchers’ perceived barriers to sharing study results with participants. Implications for policy and practice suggest that additional resources and training could help reduce dissemination barriers and increase the return of results to participants.
Introduction: ex-specific diagnostic cutoffs may improve the test characteristics of high-sensitivity troponin assays for the diagnosis of myocardial infarction. Sex-specific cutoffs for ruling in MI improve the sensitivity of the assay for MI among women, and improve the specificity of diagnosis among men. We hypothesized that the use of sex-specific high-sensitivity Troponin T (hsTnT) cutoffs for ruling out MI at the time of ED arrival would improve the classification efficiency of the assay by enabling more patients to have MI ruled out at the time of ED arrival while maintaining diagnostic sensitivity. The objective of this study was to quantify the test characteristics of sex-specific cutoffs of an hsTnT assay for acute myocardial infarction (AMI) when performed at ED arrival in patients with chest pain. Methods: This retrospective study included consecutive ED patients with suspected cardiac chest pain evaluated in four urban EDs were, excluding those with ST-elevation AMI, cardiac arrest or abnormal kidney function. The primary outcomes was AMI at 7 days. Secondary outcomes included major adverse cardiac events (MACE: all-cause mortality, AMI and revascularization) and the individual MACE components. We quantified test characteristics (sensitivity, negative predictive value, likelihood ratios and proportion of patients ruled out) for multiple combinations of sex-specific rule-out cutoffs. We calculated net reclassification improvement compared to universal rule-out cutoffs of 5ng/L (the assays limit of detection) and 6ng/L (the FDA-approved limit of quantitation for US laboratories). Results: 7130 patients, including 3931 men and 3199 women, were included. The 7-day incidence of AMI was 7.38% among men and 3.78% among women. Universal cutoffs of 5 and 6 ng/L ruled out AMI with 99.7% sensitivity in 33.6 and 42.2% of patients. The best-performing combination of sex-specific cutoffs (8g/L for men and 6ng/L for men) ruled out AMI with 98.7% sensitivity in 51.9% of patients. Conclusion: Sex-specific hsTnT cutoffs for ruling out AMI at ED arrival may achieve substantial improvement in classification performance, enabling more patients to be ruled out at ED arrival, while maintaining acceptable diagnostic sensitivity for AMI. Universal and sex-specific rule-out cutoffs differ by only small changes in hsTnT concentration. Therefore, these findings should be confirmed in other datasets.
Introduction: Patients with chronic kidney disease (CKD) are at high risk of cardiovascular events, and have worse outcomes following acute myocardial infarction (AMI). Cardiac troponin is often elevated in CKD, making the diagnosis of AMI challenging in this population. We sought to quantify test characteristics for AMI of a high-sensitivity troponin T (hsTnT) assay performed at emergency department (ED) arrival in CKD patients with chest pain, and to derive rule-out cutoffs specific to patient subgroups stratified by estimated glomerular filtration rate (eGFR). We also quantified the sensitivity and classification performance of the assays limit of detection (5 ng/L) and the FDA-approved limit of quantitation (6 ng/L) for ruling out AMI at ED arrival. Methods: Consecutive patients in four urban EDs from the 2013 calendar year with suspected cardiac chest pain who had a Roche Elecsys hsTnT assay performed on arrival were included f. This analysis was restricted to patients with an eGFR< 60 ml/min/1.73m2. The primary outcome was 7-day AMI. Secondary outcomes included major adverse cardiac events (death, AMI and revascularization). Test characteristics were calculated and ROC curves were generated for eGFR subgroups. Results: 1416 patients were included. 7-day AMI incidence was 10.1%. 73% of patients had an initial hsTnT concentration greater than the assays 99th percentile (14 ng/L). TCurrently accepted cutoffs to rule out MI at ED arrival ( 5 ng/L and 6 ng/L) had 100% sensitivity for AMI, but no patients with an eGFR less than 30 ml/min/1.73M had hsTnT concentrations below these thresholds. We derived eGFR-adjusted cutoffs to rule out MI with sensitivity >98% at ED arrival, which were able to rule out 6-42% of patients, depending on eGFR category. The proportion of patients able to be accurately ruled-in with a single hsTnT assay was substantially lower among patients with an eGFR <30 ml/min/1.73m2 (6-20% vs 25-43%). We also derived eGFR-adjusted cutoffs to rule-in AMI with specificity >90%, which accurately ruled-in up to 18% of patients. Conclusion: Cutoffs achieving acceptable diagnostic performance for AMI using single hsTnT sampling on ED arrival may have limited clinical utility, particularly among patients with very low eGFR. The ideal diagnostic strategy for AMI in patients with CKD likely involves serial high-sensitivity troponin testing with diagnostic thresholds customized to different eGFR categories.
We consider pressure-driven flow of an ion-carrying viscous Newtonian fluid through a non-uniformly shaped channel coated with a charged deformable porous layer, as a model for blood flow through microvessels that are lined with an endothelial glycocalyx layer (EGL). The EGL is negatively charged and electrically interacts with ions dissolved in the blood plasma. The focus here is on the interplay between electrochemical effects, and the pressure-driven flow through the microvessel. To analyse these effects we use triphasic mixture theory (TMT) which describes the coupled dynamics of the fluid phase, the elastic EGL, ion transport within the fluid and electric fields within the microvessel. The resulting equations are solved numerically using a coupled boundary–finite element method (BEM-FEM) scheme. However, in the physiological regime considered here, ion concentrations and electric potentials vary rapidly over a thin transitional region (Debye layer) that straddles the lumen–EGL interface, which is difficult to resolve numerically. Accordingly we analyse this region asymptotically, to determine effective jump conditions across the interface for BEM-FEM computations within the bulk EGL/lumen. Our results demonstrate that ion–EGL electrical interactions can influence the near-wall flow, causing it to become reversed. This alters the stresses exerted upon the vessel wall, which has implications for the hypothesised role of the EGL as a transmitter of mechanical signals from the blood flow to the endothelial vessel surface.
To assess the feasibility and clinical value of using the CellSearch system to detect circulating tumour cells in patients with advanced-stage head and neck squamous cell carcinoma.
Circulating tumour cells were isolated and counted via positive selection utilising magnetically labelled anti-epithelial cell adhesion molecule and immunocytochemical staining for cytokeratin. The correlation between circulating tumour cell presence and clinical features was evaluated in nine patients newly diagnosed with advanced-stage (stage III or IV) head and neck squamous cell carcinoma.
Circulating tumour cells were detected in three of the nine patients (33 per cent). Circulating tumour cell positivity was more prevalent in node stage 2 to 3 patients (3 of 5, 60 per cent) than node stage 0 to 1 patients (0 of 4, 0 per cent). Recurrent or progressive disease was observed in only one of the six patients (17 per cent) without circulating tumour cells, compared with two of the three patients (67 per cent) with circulating tumour cells.
In this preliminary study, circulating tumour cells were successfully isolated in patients with advanced-stage head and neck squamous cell carcinoma, using the CellSearch system. Further investigation is needed to evaluate the prognostic significance of circulating tumour cells.
Grasslands are the most extensive terrestrial landscapes and ecosystems in China and face growing degradation. A policy to protect the grasslands established in 2001 (the Grassland Ban Policy [GBP]), involves four management practices including grazing bans, keeping grasslands fallow, grazing rotations and rearing livestock in sheds. A questionnaire was developed and used to establish attitudes towards and beliefs about the GBP in different sectors (farming households, local officials and extension workers), assess problems with GBP implementation and identify possible solutions. Acceptance of the GBP by farmers varied from 64% in the north to 95% in the north-west region. The responses of both local officials and extension workers indicated that GBP implementation was greater in the central region than in the north-west region. Most farmers changed their livestock production system from grazing to stall feeding after implementation of the GBP, while both farmers and extension workers reported that high input costs were the most serious problem in stall feeding. Incentives need to be provided for sustainable implementation of the GBP by different stakeholders. Improved collaboration among farmers, local officials and extension workers is needed for technology transfer and policy implementation. Furthermore, the role of non-governmental organizations needs to be strengthened in implementation of the GBP.
We present an analysis of our deep far- (FUV) and near-ultraviolet (NUV) photometry of the core region of the dense globular cluster M 15. Our FUV-NUV colour-magnitude diagram (CMD) is the deepest one presented for a globular cluster so far, and shows all hot stellar populations expected in a globular cluster, such as horizontal branch stars, blue stragglers, white dwarfs, cataclysmic variables and even main sequence stars. The main sequence turn-off is clearly visible and the main sequence stars form a prominent track that extends at least two magnitudes below the main sequence turn-off. We compare and discuss the radial distribution of the various stellar populations that show up in the FUV. We search for variability amongst our FUV sources and tentatively classify our variable candidates based on an analysis of the UV colours and variability properties. We find that RR Lyraes, Cepheids, and SX Phoenicis exhibit massive variability amplitudes in this waveband (several mags).
The Radiological Protection Institute of Ireland (RPII) monitors airborne radioactivity concentrations at ten stations throughout Ireland, of which nine are equipped with low volume particulate samplers and one, in Dublin, with a high volume particulate sampler. The low volume particulate samples are assessed for total beta activity. In the period 1998-2003 the total beta activity concentrations observed have been consistently low, ranging between 0.03 and 1.33 mBq m-3 with a mean over all sampling sites of 0.26 ± 0.15 mBq m-3 (n = 2361). High volume particulate samples have been assessed for caesium-137 and beryllium-7. A mean caesium-137 activity concentration of 2.3 ± 2.2 mBq m-3 (n = 26) was observed in samples taken since 1993 while the mean beryllium-7 activity concentration over this period was 3.0 ± 1.6 mBq m-3 (n = 42).
In addition, air sampled at the RPII's laboratory in Dublin, is monitored for krypton-85, a radioactive noble gas, released into the environment primarily as a result of the reprocessing of nuclear fuel at installations such as Sellafield in the UK and Cogema La Hague in France. Analysis of the krypton-85 monitoring data, along with additional backward air trajectory modelling, demonstrate the influence of the reprocessing plants on the krypton-85 concentrations in Ireland.
The Radiological Protection Institute of Ireland has monitored levels of anthropogenic radionuclides in the Irish marine environment for over 20 years. While the primary objective of the monitoring programme is to assess the exposure of the Irish population resulting from the presence of these radionuclides in the marine environment, the programme also aims to assess the geographical distribution and temporal variations of the radionuclides. The programme involves the routine sampling of and testing for radioactivity in fish, shellfish, seaweed, sediments and seawater. The data generated in the course of this programme, as well as in a separate study of changing plutonium isotopic ratios in Fucus vesiculosus from the west coast of Ireland, were used to estimate transport times from the Sellafield nuclear fuel reprocessing plant to various locations on the Irish coastline. For conservative radionuclides, transit times of 5-6 months to the NE coast of Ireland, 1-3 years to the south coast of Ireland and 3-8 years to the west coast were calculated. In contrast, for plutonium, the Sellafield signal was not observed on the west coast until the late 1980s/early 1990s.
In the filled gallium-germanium clathrates, R8Ga16Ge30, where R is Ba, Sr, or Eu, the guests are located in two large cages and are weakly bound to the crystalline clathrate framework. The caged guests exhibit a localized “rattling” vibrational mode that provides an efficient mechanism for reducing the thermal conductivity. Inelastic neutron scattering and nuclear inelastic scattering measurements have yielded the phonon density of states in R8Ga16Ge30; the line width of the localized vibrational modes is found to be an important parameter in determining the lattice thermal conductivity. Neutron diffraction studies on R8Ga16Ge30 have shown that the guests in the larger cage are located off-center, and it was proposed that their jumping about the four off-center locations is responsible for the observed glass-like thermal conductivity at temperatures below 10 K. The detection of such slow guest motion is challenging because the typical time and energy scales involved are ca. 4 ns and 1 µeV, respectively. We have studied the slow europium tunneling dynamics in Eu4Sr4Ga16Ge30 by both Mössbauer and microwave absorption spectroscopy.
Far-ultraviolet (FUV) observations with the Hubble Space Telescope are an excellent way to find and study the hot, blue stellar populations in the cores of globular clusters. These populations include dynamically formed blue stragglers and interacting binaries (such as cataclysmic variables, i.e. the products of stellar collisions and near misses. Using the cluster 47 Tuc as an example, we show how the combination of FUV imaging and slitless spectroscopy can be used to uncover and study these populations.
We present initial results of a survey of the FUV spectra of disk-accreting cataclysmic variables obtained with the Far Ultraviolet Spectroscopic Explorer (FUSE).
FUSE covers the 905 - 1188 Å range at spectral resolutions ≃0.1 Å. To date, FUSE has observed more than 65 cataclysmic variables (CVs). Publicly-available data include observations of 11 dwarf novae (DN), 15 non-magnetic novalikes (NLs), 7 intermediate polars and DQ Her stars, at least 15 polars, and 4 super-soft X-ray binaries.
Coeval shell and charcoal from Santa Catarina State, Brazil, differ systematically in 14C content, indicating a reservoir effect in marine samples. For modern samples (AD 1939–2000) and archeological samples (2500–1595 BP), the mean 14C age difference between marine and atmospheric carbon is 220 ± 20 years, the marine carbon being older. For three samples dated AD 1939–1944, a distinct reservoir correction of 510 ± 10 years is also observed. The ages of archeological shell samples from Jabuticabeira may be corrected by subtracting 220 years from the apparent 14C ages.
Direct methanol fuel cells (DMFCs) offer a simpler, safer technology for point-of-use power sources compared to other hydrogen fuel cells, by avoiding the need to store hydrogen fuel or to carry out the reformation of hydrocarbons. The direct methanol oxidation electrocatalyst of choice is a nanoscale black consisting of a 50:50 atom % mixture of Pt and Ru. It has recently become known that these presumed bimetallic alloys in fact contain an array of metal, oxide and hydrous phases, which are easily misidentified in routine x-ray diffraction measurements due to particle size-broadening and poor crystallinity. By combining transmission electron microscopy, electrochemistry and thermogravimetric studies, we demonstrate here that the route to improved catalytic activity is not by phase purification of the bimetallic alloys, but instead phase engineering of hydrous ruthenium oxide and Pt mixtures.