Clinical outcomes of repetitive transcranial magnetic stimulation (rTMS) for treatment of treatment-resistant depression (TRD) vary widely and there is no mood rating scale that is standard for assessing rTMS outcome. It remains unclear whether TMS is as efficacious in older adults with late-life depression (LLD) compared to younger adults with major depressive disorder (MDD). This study examined the effect of age on outcomes of rTMS treatment of adults with TRD. Self-report and observer mood ratings were measured weekly in 687 subjects ages 16–100 years undergoing rTMS treatment using the Inventory of Depressive Symptomatology 30-item Self-Report (IDS-SR), Patient Health Questionnaire 9-item (PHQ), Profile of Mood States 30-item, and Hamilton Depression Rating Scale 17-item (HDRS). All rating scales detected significant improvement with treatment; response and remission rates varied by scale but not by age (response/remission ≥ 60: 38%–57%/25%–33%; <60: 32%–49%/18%–25%). Proportional hazards models showed early improvement predicted later improvement across ages, though early improvements in PHQ and HDRS were more predictive of remission in those < 60 years (relative to those ≥ 60) and greater baseline IDS burden was more predictive of non-remission in those ≥ 60 years (relative to those < 60). These results indicate there is no significant effect of age on treatment outcomes in rTMS for TRD, though rating instruments may differ in assessment of symptom burden between younger and older adults during treatment.

The circumscription of the lichenized ascomycete genus Icmadophila Trevis. in the family Icmadophilaceae Triebel was investigated. Sequences of the internal transcribed spacer (ITS) region and large subunit of nuclear ribosomal DNA (nuLSU) were generated for the five Icmadophila species and additional members of Icmadophilaceae from the genera Dibaeis, Endocena, Knightiella, Siphula, Siphulella and Thamnolia. Phylogenetic analyses indicate that three Icmadophila species are closely related: the type, I. ericetorum (L.) Zahlbr., which is widespread in Eurasia and North America, I. aversa (Nyl.) Rambold & Hertel from Central and South America, and I. japonica (Zahlbr.) Rambold & Hertel, which is restricted to Far East Russia and Japan. The genus Knightiella Müll. Arg. is reinstated to accommodate I. splachnirima (Hook.f. & Taylor) D. J. Galloway emend. L. Ludw., which occurs in New Zealand and Australia. Two further species of Knightiella, K. eucalypti (Kantvilas) Kantvilas and K. queenslandica Kantvilas, are found to be unrelated to K. splachnirima, and are accommodated in two newly described genera, Knightiellastrum and Siphulopsis respectively. Knightiellastrum L. Ludw. & Kantvilas is characterized by a squamulose, erhizinate, whitish to pale grey thallus with a green, coccoid photobiont and by containing thamnolic acid. Siphulopsis Kantvilas & A. R. Nilsen is similarly characterized by an erhizinate, whitish to pale grey thallus, with a green, coccoid photobiont and containing thamnolic acid, but is instead fruticose. This study reveals considerable diversity within Australasian Icmadophilaceae; ongoing work in the Southern Hemisphere and tropical regions may reveal additional species in this family and clarify the relationships of these newly described genera.

We present here the low-dispersion optical spectra of 295 QSO candidates. The great majority of the objects were originally selected as QSOs from the Parkes 2700 MHz radio survey, although we have also included spectra of several optically selected QSOs. A few of the QSO candidates are now better described as radio galaxies and BL Lac objects. This collection of spectra is not suitable for statistical studies unless due consideration is given to selection effects.

The history of leadership change in the Chinese Communist Party (CCP) exemplifies Pareto's notion of circulation of the elite. To analyze it we have compiled a partially ranked dataset of members and alternates of the Politburo Standing Committee, Politburo, and Central Committee for the 1st through 18th National Party Congresses. Quantitative studies of leadership change in the CCP have typically focused on the fraction of new members in each political body from one Party Congress to the next, but the existence of partially ranked data calls for a more subtle quantification of leadership change. Thus, we define a new family of metrics which consider change within each political body, the magnitude of such change, and the importance of each change to CCP structure and policy. We use two of these metrics to compute the distances between each pair of successive, partially-ranked leadership lists in our dataset. Our results capture important political developments from the irregular leadership change of the early years to the subsequent transformation of the CCP into a more institutionalized polity. This metric-based analysis also supplements our understanding of anomalous leadership transitions, intra-Party dynamics, and systemic change in the CCP.

Objectives: Medical technology is a large and expanding industry. Introducing new medical devices is important but several challenges exist in implementing the optimal method of evaluation. Both objective and subjective measures can be used for evaluation. The former is the mainstay of evaluation, yet subjective assessment is often the basis for the introduction of new medical technology. The aim of this study was to determine the interaction and concordance between objective and subjective assessment of new medical technology.

Methods: This study used both objective performance measures and subjective user perceptions in the evaluation of a new medical device designed to improve the accuracy of gravity-assisted delivery of intravenous fluids, compared with the current, widely used “roller-clamp” device. The concordance of objective and subjective assessments was evaluated using comparative analysis.

Results: Objective assessment of the accuracy of intravenous fluid delivery revealed no difference between the two devices (p = .636). Subjective assessment revealed that the new device was perceived to be significantly more accurate (p = .001). This lack of concordance can be partially explained by both device and demand characteristics.

Conclusions: This case study reveals a significant discordance between the objective and subjective assessments. It provides some explanation for why new medical devices are adopted without objective evidence of benefit. This phenomenon has been termed “persuasive design” and its influence should be controlled for in the evaluation, purchase and introduction of new medical devices. This should help reduce the risk and associated cost of premature introduction.

Bacterial biofilms are interface-associated colonies of bacteria embedded in an extracellular matrix that is composed primarily of polymers and proteins. They can be viewed in the context of soft matter physics: the rigid bacteria are analogous to colloids, and the extracellular matrix is a cross-linked polymer gel. This perspective is beneficial for understanding the structure, mechanics, and dynamics of the biofilm. Bacteria regulate the water content of the biofilm by controlling the composition of the extracellular matrix, and thereby controlling the mechanical properties. The mechanics of well-defined soft materials can provide insight into the mechanics of biofilms and, in particular, the viscoelasticity. Furthermore, spatial heterogeneities in gene expression create heterogeneities in polymer and surfactant production. The resulting concentration gradients generate forces within the biofilm that are relevant for biofilm spreading and survival.

Escherichia coli is an indicator of fecal pollution used to mandate recreational and drinking water quality. Concentrations of culturable E. coli following contamination of surface water are determined by three factors: dilution; cell attachment to particulate material and settling or resuspension in the water column; and the net rate of change in viability. This study evaluated the variability in the latter parameter, and how predictive variation in death rate was of culturable population densities at the time of sampling. Water samples (N=232) with varying levels of E. coli contamination were collected from 46 discrete locations in four watersheds across Canada over a three-month period and enumerated for culturable E. coli by membrane filtration plate counting (T0EC). Water samples were again enumerated following a laboratory 24 h holding period at 30°C in the dark, and the difference considered the death rate (ΔEC). Relationships of T0EC and ΔEC with environmental and water chemistry factors were explored using step-wise multiple regression. The model predicting T0EC indicated that stream order, total rainfall seven days in advance of sampling day, total phosphorus, and ΔEC were the most significant contributors. The model predicting ΔEC indicated that turbidity and NH3+NH4 were the most important contributors. A model suggests that the persistence factor is less important than dilution (i.e. stream order) in describing E. coli densities, followed by factors that influence the loading of E. coli into watersheds.

Background: Computer-guided CBT has been shown to be a potentially useful way of closing the gap between the demand and supply for CBT. Moreover, this approach has additional benefits in terms of less travel times for treatment, accessibility in remote and unusual locations, increased confidentiality, easier disclosure of sensitive information, and more egalitarian therapist-client interactions. Research on computerized CBT has concentrated on clinical outcomes, but the views of clients on this treatment approach have been relatively neglected. Aims: The aims were to assess client satisfaction, professionals' views, and ease of programme use after completion of treatment via an internet-based CBT programme for panic and phobic anxiety (FearFighter). Method: A feasibility and effectiveness study of FearFighter was conducted in remote and rural areas of Scotland. Treatment data are available for 35 clients at post-treatment, of whom 29 completed an 18-item set of rating scales designed to assess satisfaction, including ease of use, accessibility, how far needs were met, whether changes to the programme were required, the benefits and drawbacks of not having a therapist, and quality of support. Open-ended questions were included. Referring agencies were also asked to rate their views on FearFighter. Results: Clients reported moderate to high levels of improvement and of overall satisfaction; very few difficulties in logging on to and using the programme were encountered. Similar levels of satisfaction with the programme were reported by referrers. Conclusions: It is concluded that computer-guided CBT is acceptable to clients and to professionals, and that it could play a valuable part in a “stepped care” system of delivering CBT.

Evaluations of computer-guided CBT (CCBT) suggest that this is a promising approach to closing the gap between the demand for, and the supply of, CBT. However, additional studies are required that are conducted by researchers independent of the programme developers, and include a wider range of participants. This independent study examined the viability of CCBT for panic and phobic anxiety in an unselected sample of referrals in remote and rural areas of Scotland. Outcome was assessed by a wide range of outcome measures, completed before and after treatment, and at 4-month follow-up. Participants experienced few difficulties in using the programme, and GPs and participants regarded CCBT as acceptable and useful. Major improvements were obtained, with several large effect sizes, which remained at follow-up. It was concluded that computer-guided CBT can play a useful part in delivering CBT services in rural areas; and that self-help CBT may be the only treatment option available to some sufferers.

Discovering a theory of change for health promotion in small- and medium-sized enterprises highlights important lessons about how successful workplace health interventions work and the conditions conducive to positive outcomes for ‘hard to reach groups’. In the evaluation of targeted health promotion initiatives carried out by the Workwell project in Sandwell, a theory of change has emerged that indicates the need for a sensitive understanding of the contexts of interventions and the importance of developing mechanisms appropriate to local conditions and stakeholder expectations.

A variety of polymer materials including polyimide (PI), polyarylate (PAR), polynorbonene (PNB) and polyethersulphone (PES) have been studied for use as substrates in the formation of active matrix displays based upon polycrystalline silicon (poly-Si) thin film transistors (TFTs). A process used to fabricate transflective mobile phone displays at 250°C on such substrates is described in detail. The NMOS TFTs show a mobility of 100cm2/Vs, and a threshold voltage of 3.9V; the PMOS devices have a mobility of 52cm2/Vs, and a threshold voltage of -6V. Issues relating to performance of these devices, yield of the arrays, and manufacturability are discussed.

A side-by-side comparison of the TiO2 deposition kinetics and the corresponding film microstructures using titanium(IV) isopropoxide and anhydrous titanium(IV) nitrate was conducted at low pressures (< 10−4 Torr) in an ultrahigh vacuum chemical vapor deposition reactor. Titanium(IV) nitrate exhibited a lower activation energy of reaction (Er= 98 kJ/mol) which allowed deposition at lower temperatures compared to titanium(IV) isopropoxide (Er= 135 kJ/mol). Comparison of the microstructures of films deposited at similar temperatures revealed significant differences in the reaction rate limited kinetic regime. As the growth rates of the two precursors converged in the flux-limited regime, the respective microstructures became indistinguishable.

The synthesis, structure/property behavior of inorganic-organic hybrid network materials prepared by the sol gel process have been chronologically reviewed with emphasis on those systems prepared in the authors laboratory. Specific features of reactions as well as the nature of reactants are included. The morphological features of these “ceramer” systems formed have many features in common even though the reactants may be quite different. The mechanical properties of the final materials in conjunction with SAXS have proven beneficial in establishing the basics of their morphological texture. Finally, it is demonstrated how microwave radiation in some cases, can serve as an efficient way in processing the ceramer systems.