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There is a lack of evidence pointing to the efficacy of any specific psychotherapy for adults with anorexia nervosa (AN). The aim of this study was to compare three psychological treatments for AN: Specialist Supportive Clinical Management, Maudsley Model Anorexia Nervosa Treatment for Adults and Enhanced Cognitive Behavioural Therapy.
A multi-centre randomised controlled trial was conducted with outcomes assessed at pre-, mid- and post-treatment, and 6- and 12-month follow-up by researchers blind to treatment allocation. All analyses were intention-to-treat. One hundred and twenty individuals meeting diagnostic criteria for AN were recruited from outpatient treatment settings in three Australian cities and offered 25–40 sessions over a 10-month period. Primary outcomes were body mass index (BMI) and eating disorder psychopathology. Secondary outcomes included depression, anxiety, stress and psychosocial impairment.
Treatment was completed by 60% of participants and 52.5% of the total sample completed 12-month follow-up. Completion rates did not differ between treatments. There were no significant differences between treatments on continuous outcomes; all resulted in clinically significant improvements in BMI, eating disorder psychopathology, general psychopathology and psychosocial impairment that were maintained over follow-up. There were no significant differences between treatments with regard to the achievement of a healthy weight (mean = 50%) or remission (mean = 28.3%) at 12-month follow-up.
The findings add to the evidence base for these three psychological treatments for adults with AN, but the results underscore the need for continued efforts to improve outpatient treatments for this disorder.
Zeeman-Doppler Imaging enables one to estimate the short term temporal evolution of surface brightness and magnetic structures, under the effect of differential rotation. We present here spectropolarimetric observations secured between 1998 and 2002 for two evolved active stars: the K1 subgiant of the RS CVn system HR 1099 and the single FK Com giant HD 199178. Differential rotation is detected both from brightness and magnetic images, indicating that the rotational shear, roughly solar in magnitude for the single star, is significantly weaker in the binary system. This result suggests that tidal forces, rather than stellar evolution, could be responsible for the lower rotational shear and thus the longer spot lifetime reported for binary systems.
We investigated the genetic and environmental contributions to disordered eating (DE) between early and late adolescence in order to determine whether different sources of heritability and environmental risk contributed to these peak times of emergence of eating disorders.
Adolescent female twins from the Australian Twin Registry were interviewed over the telephone with the Eating Disorder Examination (EDE). Data were collected at 12–15 and 16–19 years (wave 1: N = 699, 351 pairs; wave 3: N = 499, 247 pairs). Assessments also involved self-report measures related to negative life events and weight-related peer teasing.
Unstandardized estimates from the bivariate Cholesky decomposition model showed both genetic influences and non-shared environmental influences increased over adolescence, but shared environmental influences decreased. While non-shared environmental sources active at ages 12–15 years continued to contribute at 16–19 years, new sources of both additive genetic and non-shared environmental risk were introduced at ages 16–19 years. Weight-related peer teasing in early-mid adolescence predicted increases of DE in later adolescence, while negative life events did not.
Two-thirds of the heritable influence contributing to DE in late adolescence was unique to this age group. During late adolescence independent sources of genetic risk, as well as environmental influences are likely to be related in part to peer teasing, appear key antecedents in growth of DE.
Large numbers of evacuees arrived in Dallas, Texas, from Hurricanes Katrina and Rita just 3 weeks apart in 2005 and from Hurricanes Gustav and Ike just 3 weeks apart again in 2008. The Dallas community needed to locate, organize, and manage the response to provide shelter and health care with locally available resources. With each successive hurricane, disaster response leaders applied many lessons learned from prior operations to become more efficient and effective in the provision of services. Mental health services proved to be an essential component. From these experiences, a set of operating guidelines for large evacuee shelter mental health services in Dallas was developed, with involvement of key stakeholders. A generic description of the processes and procedures used in Dallas that highlights the important concepts, key considerations, and organizational steps was then created for potential adaptation by other communities. (Disaster Med Public Health Preparedness. 2015;9:423–429)
Helicobacter pylori imparts a considerable burden to public health. Infections are mainly acquired in childhood and can lead to chronic diseases, including gastric ulcers and cancer. The bacterium subsists in water, but the environment's role in transmission remains poorly understood. The nationally representative National Health and Nutrition Examination Survey (NHANES) was examined for environmental risk factors associated with H. pylori seroprevalence. Data from 1999–2000 were examined and weighted to represent the US population. Multivariable logistic regression estimated adjusted odds ratios (aOR) and 95% confidence intervals (CI) for associations with seropositivity. Self-reported general health condition was inversely associated with seropositivity. Of participants aged <20 years, seropositivity was significantly associated with having a well as the source of home tap water (aOR 1·7, 95% CI 1·1–2·6) and living in a more crowded home (aOR 2·3, 95% CI 1·5–3·7). Of adults aged ⩾20 years, seropositivity was not associated with well water or crowded living conditions, but adults in soil-related occupations had significantly higher odds of seropositivity compared to those in non-soil-related occupations (aOR 1·9, 95% CI 1·2–2·9). Exposures to both well water and occupationally related soil increased the effect size of adults' odds of seropositivity compared to non-exposed adults (aOR 2·7, 95% CI 1·3-5·6). Environmental exposures (well-water usage and occupational contact with soil) play a role in H. pylori transmission. A disproportionate burden of infection is associated with poor health and crowded living conditions, but risks vary by age and race/ethnicity. These findings could help inform interventions to reduce the burden of infections in the United States.
A randomized controlled trial of three school-based programs and a no-intervention control group was conducted to evaluate their efficacy in reducing eating disorder and obesity risk factors.
A total of 1316 grade 7 and 8 girls and boys (mean age = 13.21 years) across three Australian states were randomly allocated to: Media Smart; Life Smart; the Helping, Encouraging, Listening and Protecting Peers (HELPP) initiative; or control (usual school class). Risk factors were measured at baseline, post-program (5 weeks later), and at the 6- and 12-month follow-ups.
Media Smart girls had half the rate of onset of clinically significant concerns about shape and weight than control girls at the 12-month follow-up. Media Smart and HELPP girls reported significantly lower weight and shape concern than Life Smart girls at the 12-month follow-up. Media Smart and control girls scored significantly lower than HELPP girls on eating concerns and perceived pressure at the 6-month follow-up. Media Smart and HELPP boys experienced significant benefit on media internalization compared with control boys and these were sustained at the 12-month follow-up in Media Smart boys. A group × time effect found that Media Smart participants reported more physical activity than control and HELPP participants at the 6-month follow-up, while a main effect for group found Media Smart participants reported less screen time than controls.
Media Smart was the only program to show benefit on both disordered eating and obesity risk factors. Whilst further investigations are indicated, this study suggests that this program is a promising approach to reducing risk factors for both problems.
We present a preliminary 3D potential field extrapolation model of the joint magnetosphere of the close accreting PMS binary V4046 Sgr. The model is derived from magnetic maps obtained as part of a coordinated optical and X-ray observing program.
We study the photocurrent from photoexcited charged carriers excited with lasers of energy both above and below the energy gap in CdS nanostructures. We observe non-linear photocurrents in CdS nanosheet devices in the metal-semiconductor-metal configuration with Schottky contacts for sub-band gap excitations. Analysis of two-photon absorption dominated photocurrents reveals a nonlinear coefficient of β = 2 cm/GW for these nanosheet devices, which is comparable to those of bulk CdS. We demonstrate the use of the photocurrent polarization measurements to determine the orientation of atoms in the nanosheet.
Early vigour in wheat (Triticum aestivum) is an important physiological trait to improve water-use efficiency and grain yield, especially on light soils in Mediterranean-type climates. Potential interactions for plant stand and seedling vigour between seed density and various seed quality treatments were examined for wheat grown in two experiments, conducted under controlled and field environments in Western Australia. Seed lots were graded into seed size classes and seed density fractions using saturated solutions of ammonium sulphate or sodium polytungstate. Dense seed improved plant stands or produced seedlings with greater early seedling vigour than their low-density counterparts in all three field environments. Artificial ageing reduced germination and emergence in the controlled environment. When grown in the field at Merredin, Western Australia, on the sandy soil, plant development was delayed with aged seed, and total leaf area and dry weight of plants were reduced. Fungicide application diminished total plant dry weight in sandy soils, but had a much larger detrimental effect when applied to aged and low-density seeds than normal seeds, retarding development, total leaf area and total plant dry weight. Our results indicate that an increase in seed density, particularly in small seed, can potentially improve plant stand and seedling vigour independently of seed size, and may be especially important for wheat grown on sandy soils of poor fertility and low water-holding capacity. The results also suggest consistency in seedling vigour may benefit from combined screening against small seed size and low seed density, which may also reduce the likelihood of adverse reactions to seed-applied fungicides. More attention should be paid to seed density as a valuable trait for improved reliability in plant stand and seedling vigour.
Molecular simulations that predict the molecular mechanical response of alpha-helical biopolymers with a reinforcing intra-molecular hydrogen bonding network, viz,, a ‘spring-like’ behavior, are presented in this study. Mechanical properties of extended biopolymer strands based on naturally occurring amino acids, namely poly(L-A1a) and for comparison poly(LGlu), versus synthetic PPTA containing an amide bond, are compared to those assuming alpha-helical structures. Thus, the pivotal role of such motifs in biological systems utilizing superior compressive mechanical properties can be inferred.
Three cognitive constructs are risk factors for eating disorders: undue influence of weight and shape, concern about weight and shape, and body dissatisfaction (BD). Undue influence, a diagnostic criterion for eating disorders, is postulated to be closely associated with self-esteem whereas BD is postulated to be closely associated with body mass index (BMI). We understand less about the relationships with concern about weight and shape. The aim of the current investigation was examine the degree of overlap across these five phenotypes in terms of latent genetic and environmental risk factors in order to draw some conclusions about the similarities and differences across the three cognitive variables.
A sample of female Australian twins (n=1056, including 348 complete pairs), mean age 35 years (s.d.=2.11, range 28–40), completed a semi-structured interview about eating pathology and self-report questionnaires. An independent pathways model was used to investigate the overlap of genetic and environmental risk factors for the five phenotypes.
In terms of variance that was not shared with other phenotypes, self-esteem emerged as being separate, with 100% of its variance unshared with the other phenotypes, followed by undue influence (51%) and then concern (34%), BD (28%) and BMI (32%).
In terms of shared genetic risk, undue influence and concern were more closely related than BD, whereas BMI and BD were found to share common sources of risk. With respect to environmental risk factors, concern, BMI and BD were more closely related to each other than to undue influence.
A comparative study of the low temperature conductivity of an ensemble of multiwall
carbon nanotubes and semiconductor nanowires is presented. The
quasi one-dimensional samples are made in nanoporous
templates by electrodeposition and CVD growth. Three different
structures are studied in parallel: multiwall carbon nanotubes,
nanowires, and silicon nanowires. It is shown that the Coulomb blockade
regime dominates the electronic transport below 50 K, together with weak and
strong localization effects. In the Coulomb blockade regime, a
scaling law of the conductance measured as a function of the
temperature and the voltage is systematically observed. This allows
a single scaling parameter α to be defined. This parameter
accounts for the specific realization of the “disorder”, and plays
the role of a fingerprint for each sample. Correlations between
α and the conductance measured as a function of temperature
and voltage, as a function of the perpendicular magnetic field, and
as a function of the temperature and voltage in the localized regime
below 1 K have been performed. Three universal laws are reported.
They relate the coefficient α (1) to the normalized Coulomb
, (2) to the phase coherence length
, and (3) to the activation energy
. These observations suggest a description of the wires
and tubes in terms of a chain of quantum dots; the wires and tubes
break into a series of islands. The quantum dots are defined by
conducting islands with a typical length on the order of the phase
coherence length separated by poorly conducting regions (low
density of carriers or potential barriers due to defects). A
corresponding model is developed in order to put the three
universal laws in a common frame.
This study was designed to investigate potential temperament endophenotypes for clinically significant importance of shape and weight.
Seven temperament risk factors for eating disorders and the Eating Disorder Examination were assessed in 699 female twins aged 12–15 years. Each variable was evaluated against the following endophenotype criteria: associated with illness in the general population; found in non-affected family members at a higher rate than in the general population; and, heritable.
All seven variables were significantly associated with clinically significant importance of shape and weight, while thin-ideal internalization, ineffectiveness, body dissatisfaction and sensitivity to punishment were found at significantly elevated levels in non-affected twins, when controlling for sister's temperament score. These four variables had genetic correlations with importance of shape and weight, ranging from 0.48 to 0.95.
Future research should evaluate the stability of the identified endophenotypes and their utility for predicting significant growth in importance of shape and weight, and also whether different endophenotypes emerge when the importance of weight and shape reaches its peak in adolescents, around 15 to 16 years of age.
Objective binge eating (OBE) and self-induced vomiting (SIV) occur and co-occur across a range of eating disorders but the extent to which the risk factors for these two behaviours overlap is unclear. Examination of this overlap was the focus of the current report.
A population of female Australian twins (n=1002), mean age 35 years (s.d.=2.11, range 28–40), participated in three waves of data collection and were assessed for lifetime disordered eating with a semi-structured interview at wave 3 and a self-report questionnaire at wave 1; risk factors were assessed via self-report at waves 1 and 3.
Non-shared environmental influences were the largest contributor to the variance of both OBE and SIV, with a more modest contribution of genetic influences. Between 5% and 14% of the environmental risk factors for OBE and SIV were shared and 27–100% of genetic risk factors were shared. SIV initiation was predicted by higher neuroticism and novelty seeking and lower maternal and paternal care, whilst lower levels of perceived paternal care, higher lifetime BMI, and a wider BMI range predicted OBE initiation. Retrospective correlates associated with both SIV and OBE onset were parental comments about weight, whilst higher levels of parental conflict, expectations and criticism was associated with OBE onset only.
The substantial extent of non-overlap between risk factors for SIV and OBE suggests that each of these behavioural disturbances warrants future investigation in its own right, not only when they occur in conjunction with each other.
We report the discovery, using FORS1 at the ESO-VLT and ESPaDOnS at the Canada-France-Hawaii Telescope, of magnetic fields and chemical peculiarities in the Herbig Ae/Be stars HD 72106 and HD 101412. These stars may well represent pre-main sequence progenitors of the magnetic Ap/Bp stars. At the same time, we fail to confirm claims by Hubrig et al. (2004) of the presence of magnetic fields in the Herbig Ae star HD 139614.
We are conducting a magnetic survey of a sample of about 30 spectroscopically identified Ap stars, with weak or previously undetected magnetic fields. For 28 studied stars, we have obtained 25 detections of Stokes V Zeeman signatures. Our results suggest that all Ap stars are magnetic. Further there may exist a minimum field strength for which Ap-type characteristics are produced.To search for other articles by the author(s) go to: http://adsabs.harvard.edu/abstract_service.html
We describe the first results of a systematic spectropolarimetric survey of the coolest magnetic Ap stars, undertaken with the MuSiCoS spectropolarimeter, with the aim of clarifying the magnetic field and atmospheric characteristics of these enigmatic objects.To search for other articles by the author(s) go to: http://adsabs.harvard.edu/abstract_service.html
Background. There were four purposes of the current study, including the investigation of the: (i) adequacy of a multidimensional measure of body image; (ii) genetic and environmental epidemiology of this measure; (iii) shared variance between genetic and environmental risk factors for body mass index (BMI) and body image; and (iv) Equal Environment Assumption (EEA) as it related to body attitudes.
Method. Six types of body attitudes, as measured by the Body Attitudes Questionnaire (BAQ) and reported by 894 complete female–female twin pairs (mean age 32·35 years, S.D.=41·8) from the Australian Twin Registry, were analysed.
Results. Confirmatory factor analysis of the BAQ supported the adequacy of the measure. Additive genetic and unique environmental influences best accounted for the variance of all six of the BAQ subscales. The relationship between BMI and body attitudes was primarily due to shared genes rather than environment but the majority of genetic and environmental effects on body attitudes were independent of BMI, with the exception of the Feeling Fat subscale, which shared 53% of its genetic risk factors with BMI. One violation of the EEA was suggested, namely similarity of childhood treatment influenced similarity on Lower Body Fatness subscale.
Conclusions. Findings support the notion that: (i) body image is a multidimensional concept; (ii) it is relatively independent of BMI; and (iii) both genetic and non-shared environment are influential determinants of body attitudes.
This manuscript extends our previously published work (based on data from one clinic) on the association between three drinking water-treatment modalities (boiling, filtering, and bottling) and diarrhoeal disease in HIV-positive persons by incorporating data from two additional clinics collected in the following year. We conducted a cross-sectional survey of drinking water patterns, medication usage, and episodes of diarrhoea among HIV-positive persons attending clinics associated with the San Francisco Community Consortium. We present combined results from our previously published work in one clinic (n = 226) with data from these two additional clinics (n = 458). In this combined analysis we employed logistic regression and marginal structural modelling of the data. The relative risk of diarrhoea for ‘always’ vs. ‘never’ drinking boiled water was 0.68 (95% CI 0.45–1.04) and for ‘always’ vs. ‘never’ drinking bottled water was 1.22 (95% CI 0.82–1.82). Drinking filtered water was unrelated to diarrhoea [1.03 (95% CI 0.78, 1.35) for ‘always’ vs. ‘never’ drinking filtered water]. Adjustment for confounding did not have any notable effect on the point estimates (0.61, 1.35 and 0.98 for boiled, bottled, and filtered water respectively, as defined above). The risk of diarrhoea was lower among those consuming boiled water but this finding was not statistically significant. Because of these findings, the importance of diarrhoea in immunocompromised individuals, and the limitations of cross-sectional data further prospective investigations of water consumption and diarrhoea among HIV-positive individuals are needed.
In a cross-sectional survey of 226 HIV-infected men, we examined the occurrence of diarrhoea and its relationship to drinking water consumption patterns, risk behaviours, immune status and medication use. Diarrhoea was reported by 47% of the respondents. Neither drinking boiled nor filtered water was significantly associated with diarrhoea (OR = 0·5 [0·2, 1·6], 1·2 [0·6, 2·5] respectively), whereas those that drank bottled water were at risk for diarrhoea (OR = 3·0 [1·1, 7·8]). Overall, 47% always or often used at least one water treatment. Of the 37% who were very concerned about drinking water, 62% had diarrhoea, 70% always or often used at least one water treatment. An increase in CD4 count was protective only for those with a low risk of diarrhoea associated with medication (OR = 0·6 [0·5, 0·9]). A 30% attributable risk to diarrhoea was estimated for those with high medication risk compared to those with low medication risk. The significant association between concern with drinking water and diarrhoea as well as between concern with drinking water and water treatment suggests awareness that drinking water is a potential transmission pathway for diarrhoeal disease. At the same time we found that a significant portion of diarrhoea was associated with other sources not related to drinking water such as medication usage.