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The current study explored the temporal pathways of change within two treatments, the Healthy Activity Program (HAP) for depression and the Counselling for Alcohol Problems (CAP) Program for harmful drinking.
The study took place in the context of two parallel randomized controlled trials in Goa, India. N = 50 random participants who met a priori criteria were selected from each treatment trial and examined for potential direct and mediational pathways. In HAP, we examined the predictive roles of therapy quality and patient-reported activation, assessing whether activation mediated the effects of therapy quality on depression (Patient Health Questionnaire-9) outcomes. In CAP, we examined the predictive roles of therapy quality and patient change- and counter-change-talk, assessing whether change- or counter-change-talk mediated the effects of therapy quality on daily alcohol consumption.
In HAP, therapy quality (both general and treatment-specific skills) was associated with patient activation; patient activation but not therapy quality significantly predicted depression outcomes, and patient activation mediated the effects of higher general skills on subsequent clinical outcomes [a × b = −2.555, 95% confidence interval (CI) −5.811 to −0.142]. In CAP, higher treatment-specific skills, but not general skills, were directly associated with drinking outcomes, and reduced levels of counter-change talk both independently predicted, and mediated the effects of higher general skills on, reduced alcohol consumption (a × b = −24.515, 95% CI −41.190 to −11.060). Change talk did not predict alcohol consumption and was not correlated with counter-change talk.
These findings suggest that therapy quality in early sessions operated through increased patient activation and reduced counter-change talk to reduce depression and harmful drinking respectively.
Papal relations with monarchs in the later eleventh and twelfth centuries have often been characterized as ‘feudal’, as indicative of some sort of papal dominium mundi, or as an effort to advance papal ‘empire’ over the kingdoms of Christendom. More recent scholarship has drawn a distinction between ‘protection’ and ‘feudal’ relationships with kings. However, the supposed distinction between the papacy's temporal overlordship of rulers and its spiritual protection may have obscured more than it has revealed. It was only after the disputes over lay investiture of bishops in the period 1078–1122 that a distinctive protective relationship began to emerge. Previously, rulers had been willing to ‘accept their kingdom from the pope's hand’ or to participate in ceremonies of investiture. In the twelfth century these relationships became more codified and any suggestion that the papacy actually gave kingdoms to kings faded. Thus, the nature of papal ‘empire’ – or, at least, temporal authority over kings – changed markedly during this period.
Objectives: Cognitive reserve moderates the effects of gray matter (GM) atrophy on cognitive function in neurological disease. Broadly speaking, Reserve explains how persons maintain function in the face of cerebral injury in cognitive and other functional domains (e.g., physical, social). Personality, as operationalized by the Five Factor Model (FFM), is also implicated as a moderator of this relationship. It is conceivable that these protective mechanisms are related. Prior studies suggest links between Reserve and personality, but the degree to which these constructs overlap and buffer the clinical effects of neuropathology is unclear. Methods: We evaluated Reserve and FFM traits—Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness—in a cohort of 67 multiple sclerosis (MS) patients. We also examined the extent to which FFM traits and aspects of Reserve interact in predicting cognitive processing speed. Results: Retrospectively reported educational/occupational achievement was associated with higher Openness, and childhood social engagement was associated with higher Extraversion, Agreeableness, and Conscientiousness. Current involvement in exercise activities and social activities was associated with Extraversion, current involvement in hobbies was associated with Neuroticism, and current receptive behaviors were associated with Agreeableness and Conscientiousness. When tested as predictors, Conscientiousness and childhood enrichment activities interacted in predicting cognitive processing speed after accounting for age, disease duration, disability, and GM volume. Conclusions: Childhood enrichment activities and Conscientiousness have a synergistic effect on cognitive processing speed. Current findings have implications for using psychological interventions to foster both Reserve and adaptive personality characteristics to stave off clinical symptoms in MS. (JINS, 2016, 22, 920–927)
Reducing the global treatment gap for mental disorders requires treatments that are economical, effective and culturally appropriate.
To describe a systematic approach to the development of a brief psychological treatment for patients with severe depression delivered by lay counsellors in primary healthcare.
The treatment was developed in three stages using a variety of methods: (a) identifying potential strategies; (b) developing a theoretical framework; and (c) evaluating the acceptability, feasibility and effectiveness of the psychological treatment.
The Healthy Activity Program (HAP) is delivered over 6–8 sessions and consists of behavioral activation as the core psychological framework with added emphasis on strategies such as problem-solving and activation of social networks. Key elements to improve acceptability and feasibility are also included. In an intention-to-treat analysis of a pilot randomised controlled trial (55 participants), the prevalence of depression (Beck Depression Inventory II ⩾19) after 2 months was lower in the HAP than the control arm (adjusted risk ratio = 0.55, 95% CI 0.32–0.94, P = 0.01).
Our systematic approach to the development of psychological treatments could be extended to other mental disorders. HAP is an acceptable and effective brief psychological treatment for severe depression delivered by lay counsellors in primary care.
An enormous effort is underway worldwide to attempt to detect gravitational waves. If successful, this will open a new frontier in astronomy. An essential portion of this effort is being carried out in Australia by the Australian Consortium for Interferometric Gravitational Astronomy (ACIGA), with research teams working at the Australia National University, University of Western Australia, and University of Adelaide involving scientists and students representing many more institutions and nations. ACIGA is developing ultrastable high-power continuous-wave lasers for the next generation interferometric gravity wave detectors; researching the problems associated with high optical power in resonant cavities; opening frontiers in advanced interferometry configurations, quantum optics, and signal extraction; and is the world's leader in high-performance vibration isolation and suspension design. ACIGA has also been active in theoretical research and modelling of potential astronomical gravitational wave sources, and in developing data analysis detection algorithms. ACIGA has opened a research facility north of Perth, Western Australia, which will be the culmination of these efforts. This paper briefly reviews ACIGA's research activities and the prospects for gravitational wave astronomy in the southern hemisphere.
One consequence of observing from a moving platform is that all objects exhibit parallax. The measurement of parallax yields distance, a quantity useful in astrophysics. In particular, with distance we can determine the absolute magnitude of any object, a primary parameter in two of the most useful “maps” in astronomy: the Hertzsprung–Russell diagram (e.g. Perryman et al. 1997, Fig. 3), showing the relation between absolute magnitude (luminosity) and color (temperature); and the mass–luminosity relation (e.g. Henry 2004, Fig. 3), a tool for turning luminosity into mass, a stellar attribute which determines the past and future aging process for any star. Another example of the utility of absolute magnitudes is the Cepheid period–luminosity relation (PLR). The example used here to illustrate parallax determination had improving that relationship as its ultimate goal.
The technology used to generate parallaxes has proceeded from naked-eye measurements with mechanical micrometers (Bessel 1838), through hand measurements of photographic plates (Booth and Schlesinger 1922), through computer-controlled plate scanners (Auer and van Altena 1978), through computer-controlled CCD cameras (Henry et al. 2006, Harris et al. 2007), through the triumph of the Hipparcos astrometric satellite (Perryman et al. 1997), to space-borne optical interferometers (Benedict et al. 2007, 2009) and extremely long baseline radio interferometers (Reid et al. 2009). Each stage of this historical sequence is characterized by improvements in both the centering of the images of the target and reference stars and the mathematical challenge in distilling the final parallax from those centers.
Our team was awarded 108 orbits of Hubble Space Telescope time to obtain parallaxes and photometry of nine metal-poor stars with [Fe/H] < −1.5 dex. The parallaxes are obtained from observations with the Fine Guidance Sensor (FGS 1r; 11 orbits per star) and photometry was obtained with the Advanced Camera for Surveys (one orbit per star). The first data were obtained in October 2008, and the data collection is ongoing. It is anticipated that the observations will be complete in June 2013. Preliminary data reduction has been completed for five of our target stars. The parallax errors vary from 0.12 to 0.16 milli-arcseconds, and the parallaxes are at least an order of magnitude more accurate than existing Hipparcos parallaxes for these stars. The errors in the true distance modulus range from 0.02 to 0.03 mag. Ground-based high-resolution spectra have been analyzed to obtain accurate abundances for three stars. The properties of the two stars with accurate abundances and parallaxes are in excellent agreement with those predicted by stellar evolution models.
Schizophrenia has come to be viewed as a neurodevelopmental disorder that is characterized by genetic vulnerability, stressors during the prenatal period that may be marked by minor physical anomalies and neurobehavioral deficits that emerge in early development. Less is known about the neurodevelopmental origins of schizotypal personality symptoms. The present study examines schizotypal symptoms in Israeli adolescents (mean age = 16.79 years) who have not yet reached the developmental period during which first schizophrenic episode is most likely to emerge: 39 adolescent offspring of parents with schizophrenia, 39 offspring of parents with other psychiatric disorders, and 36 offspring of parents with no history of mental illness. The Semi-Structured Kiddie Interview for Personality Syndromes was used to assess cognitive–perceptual, interpersonal, and disorganized schizotypal symptoms. Interpersonal schizotypal symptoms were more prevalent in the schizophrenia offspring group than in the no-mental-illness offspring group. Among the schizophrenia offspring group, interpersonal, but not cognitive–perceptual, schizotypal symptoms were associated with minor physical anomalies, fine motor dyscoordination, and deficits in executive functioning during adolescence. Among young people whose parents did not have schizophrenia, cognitive–perceptual schizotypal symptoms were correlated with deficits in executive functioning. Adolescent schizotypal symptoms were associated with neurobehavioral symptoms measured during middle childhood in a subgroup of the sample that had been assessed prospectively. Finally, young people who had genetic risk for schizophrenia, minor physical anomalies, and neurobehavioral signs together were at markedly increased risk for symptoms of interpersonal schizotypal symptoms, compared to young people with one or none of these risk factors.
In a few years astrometry with the venerable combination of Hubble Space Telescope and Fine Guidance Sensor will be replaced by SIM, Gaia, and long-baseline interferometry. Until then we remain a resource of choice for sub-millisecond of arc precision optical astrometry. As examples we discuss 1) the uses which can be made of our parallaxes of Galactic Cepheids, and 2) the determination of perturbation orbital elements for several exoplanet host stars, yielding true companion masses.
We observed an outbreak of necrotizing fasciitis associated with Streptococcus agalactiae infection in a group of juvenile saltwater crocodiles (Crocodylus porosus). We undertook screening of crocodiles and the environment to clarify the source of the outbreak and evaluated the isolates cultured from post-mortem specimens with molecular methods to assess clonality and the presence of known group B streptococcal virulence determinants. The isolates were indistinguishable by pulsed-field gel electrophoresis. They were a typical serotype Ia strain with the Cα-like protein gene, epsilon (or alp1), the mobile genetic elements IS381 ISSag1 and ISSag2, and belonged to multi-locus sequence type (ST) 23. All of these characteristics suggest they were probably of human origin. We review the medical and veterinary literature relating to S. agalactiae necrotizing fasciitis, epidemiology and virulence determinants.
When the word “Vietnam” is mentioned, many people still think of a war that ended twenty-nine years ago. Yet Vietnam, the country, possesses the second largest population in Southeast Asia and ranks twelfth largest in the world. Surely it deserves to be approached on its own terms, not as a foreign memory.
A stern test of this prescription is to study governance in Vietnam. Undoubtedly, Vietnam's entire political system was profoundly influenced by war and revolution from 1945 to the late 1970s. On the other hand, those western writers who labelled Vietnam “totalitarian” had very little to go on except their own Cold War ideological predilections, extrapolations from Stalin's USSR, and Hanoi's determination to portray Ho Chi Minh and the Communist Party as infallible. Scholars who rejected the totalitarian epithet for Vietnam still found themselves severely limited as to sources that might support alternative models. Fieldwork was impossible, archives were closed, provincial newspapers inaccessible. By default, the utterances of central leaders and public intellectuals dominated writings on contemporary Vietnam. And governance — being inherently political — proved more difficult to research in practice than economic, social or cultural topics. Vietnam's research conditions have improved substantially during the past decade, with scholars able to reside in the countryside, some archival materials rendered accessible, and back sets of hundreds of local periodicals readily available at the National Library in Hanoi. Of equal importance, a new generation of Vietnamese and foreign scholars has emerged and is making its mark in PhD theses and publications. Growing up after the war, these young men and women are looking at received wisdom critically, asking fresh questions, and eagerly taking advantage of the wider range of study opportunities. are delighted that a number of promising young scholars are represented in this book.
While governance is the context for this book, it is still only feasible in Vietnam to examine certain aspects rigorously.
This is the first book in English to examine local government and authority in Vietnam since the country's reunification in 1975. Beyond Hanoi addresses four questions: what local institutions and offices have authority to govern; who are the local officials and how do they get their positions; what do local governments do and whose interests do they serve; and what do residents say about local officials and governing institutions?Based on in-depth research, six chapters emphasize particular villages and districts in different parts of the country, one examines a ward in Hanoi, another focuses on Ho Chi Minh City, and one compares leaders in several provinces. To contextualize conditions today, two chapters analyse local government in Vietnam's long history. The opening chapter synthesizes the findings in this book with those in other studies by researchers inside and outside Vietnam.