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Psychotic and bipolar affective disorders are considered severe mental illnesses with a long-term course and fluctuating presentation. Psychotic disorders are particularly characterized by significant changes to beliefs, cognition, and perception, and bipolar affective disorders are characterized by episodes of elevated mood (mania) and depression, as well as interepisode mood fluctuation. The symptoms and impacts of these disorders can be wide-ranging and complex and their presentations highly varied. Assessors need to be clear about the rationale, aims, and scope of their assessment in order to select appropriate assessment instruments. Generally, valid and meaningful assessments take a holistic approach and are built on thoughtful and sensitive engagement with interviewees. This chapter reviews pertinent issues and common assessment instruments for categorizing, quantifying, and formulating psychotic and bipolar affective disorders.
Traumatic brain injury is one of the most prevalent neurological disorders and has gained public attention in recent years. Depending on several factors, including level of consciousness, post-traumatic amnesia, and neuroimaging findings, brain injuries are classified as mild, moderate, or severe. Individuals with moderate to severe injuries have worse cognitive, emotional, and functional outcomes and exhibit a more prolonged recovery than those with mild injuries. Although mild injuries are usually associated with short-term cognitive and emotional difficulties that resolve within weeks, sometimes symptoms persist longer than three months. These prolonged or post-concussion syndrome symptoms are not related to the injury itself but rather are influenced by prior and current psychological symptoms. As individuals with varying levels of brain injury progress through acute, subacute, and chronic stages of their recovery, neuropsychological evaluations are used to assess cognitive and emotional functioning, predict outcomes, and provide treatment recommendations.
This chapter offers a succinct overview of the successive stages in the development of the architectural memorial, starting in the period of the two world wars and concluding with a discussion of the practices and debates of the early twenty-first century. In addition to sketching broad trends and important points of dispute and discussion, it will zoom in on a few influential projects that shaped subsequent practice, such as Jochen and Esther Shalev-Gerz’s Monument Against Fascism (1986) and Maya Lin’s Vietnam Veterans Memorial (1982).
Patients with an equivalent clinical background may show unexpected interindividual differences in their outcome. The cognitive reserve (CR) model has been proposed to account for such discrepancies, but its role after acquired severe injuries is still being debated. We hypothesize that inappropriate investigative methods might have been used when dealing with severe patients, which have very likely reduced the possibility of observing meaningful influences in recovery from severe traumas.
To overcome this issue, the potential neuroprotective role of CR was investigated, considering a wider spectrum of clinical symptoms ranging from low-level brain stem functions necessary for life to more complex motor and cognitive skills. In the present study, data from 50 severe patients, 20 suffering from post-anoxic encephalopathy (PAE) and 30 with traumatic brain injury (TBI), were collected and retrospectively analyzed.
We found that CR, diagnosis, time of hospitalization, and their interaction had an effect on the clinical indexes. When the predictive power of CR was investigated by means of two machine learning classifier algorithms, CR, together with age, emerged as the strongest factor in discriminating between patients who reached or did not reach successful recovery.
Overall, the present study highlights a possible role of CR in shaping the recovery of severe patients suffering from either PAE or TBI. The practical implications underlying the need to routinely considered CR in the clinical practice are discussed.
Cover crops are frequently adopted to immobilize residual nitrogen post-harvest, thereby reducing potential N losses. However, the effectiveness of a cover crop depends on the species planting date, and other management practices. Limited information on N dynamics in cover crop systems is available specially in short-season vegetable rotations under temperate climate. From 2008 to 2010, a split-plot field experiment was carried out in a humid, temperate climate with cover crop treatment as the main plot factor [no cover crop control (NoCC), cereal rye, hairy vetch, oat, forage pea, oilseed radish (OSR) and a control with fertilizer N to the cucumber crop (NoCC + N)], and cover crop planting date as the split factor (early and late) to evaluate their impacts on cover crop biomass and N dynamics over the fall and following cucumber crop. All cover crop treatments significantly lowered soil mineral nitrogen (SMN) by 39–87% compared to the NoCC control, which was concomitant with cover crop growth and N accumulation. In the fall, SMN (0–90 cm depth) was less under the early-planted cover crops (avg. 78 kg N ha−1) compared to the late-planted (avg. 100 kg N ha−1). In April, greater plant available nitrogen (PAN, sum of SMN to 60 cm depth and plant N) with cover crops than without demonstrated N conservation over the winter and into the cucumber crop. Crop yield was equal to or better with a cover crop compared with the NoCC in both years; moreover, compared to the NoCC + N control yields were equivalent with OSR and pea. Oat, vetch and pea cover crops benefited the most by having an earlier planting date, while OSR and rye are recommended if the planting date is delayed. Although an early August planting date significantly increased plant N accumulation and SMN by November, this species-dependent interaction did not persist into the following season in yield and N accounted for in the system.
Throughout September and October 1918, Allied forces made a series of offensives that threatened and destabilised the last of the German Army’s defensive positions on the Western Front. The BEF broke through German lines between the Schelde and the Sambre rivers in early November, leading to the capture of hundreds of German prisoners and scores of field and heavy siege guns. Suffering a series of defeats from which it could never recover, the German Army collapsed. An armistice was signed at Compiègne on 11 November 1918, bringing an end to four years of fighting on the Western Front. German sailors of the High Seas Fleet had by then mutinied at Kiel, Kaiser Wilhelm II had abdicated and moved to Holland, and Germany was in the midst of revolution. The war had ended, and for 2.5 million Allied prisoners in German captivity, the day of being released after years of deprivation and hardship had finally arrived.
Mental health patients can experience involuntary treatment as disempowering and stigmatising, and contact with recovered peers is cited as important for countering stigma and fostering agency and autonomy integral to recovery.
To advance understanding of the interaction between involuntary treatment and contact with recovered peers, and explore hypothesised relationships to mechanisms of self-evaluation relevant to recovery.
Eighty-nine adults diagnosed with serious mental illness completed items to assess involuntary treatment experience and the extent of prior contact with recovered peers, the Internalised Stigma of Mental Illness Scale, the Self-efficacy for Personal Recovery Scale, the Questionnaire about the Process of Recovery and relevant demographic and clinical scales.
Contact with recovered peers was found to moderate the effects of involuntary treatment on internalised stigma. Sequential conditional process models (i.e. moderated mediation) then demonstrated that conditional internalised stigma (i.e. moderated by contact with recovered peers) mediated the indirect effect of involuntary treatment on recovery-specific self-efficacy, which in turn influenced recovery. Compared with those with low contact with recovered peers, recovery scores were 3.54 points higher for those with high contact.
Although study methods limit causative conclusions, findings are consistent with proposals that contact with recovered peers may be helpful for this patient group, and suggest this may be particularly relevant for those with involuntary treatment experience. Directions for future research, to further clarify measurement and conceptual tensions relating to the study of (dis)empowering experiences in mental health services, are discussed in detail.
The introduction reviews, summarizes, and illustrates fundamental connections among Bayesian inference, numerical quadrature, Gausssian process regression, polyharmonic splines, information-based complexity, optimal recovery, and game theory that form the basis for the book. This is followed by describing a sample of the results derived from these interplays; including those in numerical homogenization, operator-adapted wavelets, fast solvers, and Gaussian process regression. It finishes with an outline of the structure of the book.
This chapter introduces optimal recovery games on Banach spaces, presents their natural lift to mixed strategies, and then characterizes their saddle points in terms of Gaussian measures, cylinder measures, and fields. The canonical Gaussian field is shown to be a universal field in the sense that its conditioning with respect to linear measurements produces optimal strategies. When those measurements form a nested hierarchy, hierarchies of optimal approximations form a martingale obtained by conditioning the Gaussian field on the filtration formed by those measurements.
This chapter presents the theory of optimal recovery in the setting of Sobolev spaces and the context of information-based complexity. It also describes optimal recovery splines, their variational properties, and their minmax optimality characterization.
This chapter introduces two-person zero-sum games, optimal recovery games, and their lifts to mixed extended games and defines saddle points and minmax solutions. The optimal mixed strategy for the mixed extension of the optimal recovery games is generated by conditioning the canonical Gaussian field associated with the energy norm. Since the dependence of these optimal solutions on the measurement functions is through the conditioning process only, the canonical Gaussian field is referred to as a universal field. This fact demonstrates that the optimal solutions generated from a nested hierarchy of measurement functions form a martingale.
In the years following the September 11, 2001 terrorist attacks in New York (USA), otherwise known as 9/11, first responders and recovery workers began experiencing a range of physical and mental health challenges. Publications documenting these provide an important evidence-base identifying exposure-related health challenges associated with environmental exposures from the World Trade Center (WTC) site and describe the key lessons learned regarding both physical and mental health challenges (including symptoms and defined conditions) from the 9/11 disaster response.
A systematic literature review was conducted using the MEDLINE, PubMed, CINAHL, and PsychInfo databases (September 11, 2001 to September 11, 2018) using relevant search terms, truncation symbols, and Boolean combination functions. Publications were limited to journal articles that documented the physical or mental health challenges of 9/11 on first responders or recovery workers.
A total of 156 publications were retrieved by the search strategy. The majority (55%) reported a quantitative methodology, while only seven percent reported the use of a qualitative research methodology. Firefighters were the group of responders most frequently reported in the literature (35%), while 37% of publications reported on research that included a mix of first responders and recovery workers. Physical health was the focus of the majority of publications (57%). Among the challenges, respiratory issues were the physical health condition most frequently reported in publications, while posttraumatic stress disorder (PTSD) was the most frequent mental health condition reported on. Publications were published in a broad range of multi-disciplinary journals (n = 75).
These findings will go some way to filling the current gap in the 9/11 evidence-base regarding the understanding of the long-term health challenges for first responders and recovery workers.
This chapter explains how, by combining the trust with the ‘agency’ effects described in the previous chapters, the difficulties of each doctrine, operating in isolation, are overcome, In particular, this chapter explains how, through combination, the agency aspect of equtiable assignment becomes irrevocable; how the usual rule of agency that an agent may not sub-delegate is reversed; how substantial damages may be recovered by the assignee in right of the assignor;and how double liability of the assignor may be avoided, in part, through legislative intervention in the form of Common Law Procedure Act 1854, section 83.;
Outpatient interventions for adult anorexia nervosa typically have a modest impact on weight and eating disorder symptomatology. This study examined whether adding a brief online intervention focused on enhancing motivation to change and the development of a recovery identity (RecoveryMANTRA) would improve outcomes in adults with anorexia nervosa.
Participants with anorexia nervosa (n = 187) were recruited from 22 eating disorder outpatient services throughout the UK. They were randomised to receiving RecoveryMANTRA in addition to treatment as usual (TAU) (n = 99; experimental group) or TAU only (n = 88; control group). Outcomes were measured at end-of-intervention (6 weeks), 6 and 12 months.
Adherence rates to RecoveryMANTRA were 83% for the online guidance sessions and 77% for the use of self-help materials (workbook and/or short video clips). Group differences in body mass index at 6 weeks (primary outcome) were not significant. Group differences in eating disorder symptoms, psychological wellbeing and work and social adjustment (at 6 weeks and at follow-up) were not significant, except for a trend-level greater reduction in anxiety at 6 weeks in the RecoveryMANTRA group (p = 0.06). However, the RecoveryMANTRA group had significantly higher levels of confidence in own ability to change (p = 0.02) and alliance with the therapist at the outpatient service (p = 0.005) compared to the control group at 6 weeks.
Augmenting outpatient treatment for adult anorexia nervosa with a focus on recovery and motivation produced short-term reductions in anxiety and increased confidence to change and therapeutic alliance.
In August 2017, Hurricane Harvey struck the US Gulf Coast and caused more than US $125 billion in damages in Texas. The loss of lives and the economic damages resulted in an outpouring of support for the recovery efforts in the form of federal assistance and private donations. The latter has supported more creative approaches to recovery. Organizations that normally would not receive funding were able to obtain resources to use in novel manners. Using the framework of Dynes typology to identify groups and their respective structures and tasks, this report from the field analyzes Hurricane Harvey and the financial support mechanisms used to support recovery efforts in Texas, what organizations were funded to do, and where they fit into Dynes typology. The authors close by noting the importance of these emerging organizations and the need to support diversity in funding disaster response and recovery efforts beyond large nonprofit organizations.