Cognitive behaviour therapy for health anxiety

Commentary on: Clinical and cost-effectiveness of cognitive behaviour therapy for health anxiety in medical patients (Tyrer et al THE LANCET-D-13-04564R2

Designing Coastal Management Strategies for Populations with Distinct Needs: The Case of Learning Disabilities

The Disability Discrimination Act (DDA 1995, amended 2005), Equality Act (2010), EU Disability Action Plan (2003–2010) and EU Disability Strategy (2010–2020) were designed to make equal opportunities a ‘reality’. As 16% of the EU population is statutorily disabled, there are considerable implications for beach management. Common research examples given of beach users include swimmers, anglers and water-sport enthusiasts – but rarely people with learning disabilities (LD). This paper assessed the viewpoints of a group of beach users with LD and considered their appreciation of three different coastal classifications in South Wales, UK. Because of the nature of their disabilities, the research applied a participatory photo-interpretation methodology (photovoice) at these three beach locations. The research then compared the LD ranking of beach issues with rankings provided by members of the general public at the same beaches. The results demonstrated some similarities between LD and general public coastal needs, but identified the need for specific considerations to be made by beach managers for LD users. These included informed self-advocacy, use and application of signage, instructive access and a requirement for baseline information gathering. The research proposes an Integrated Coastal Access Model (ICAM) from which Coastal Zone Management (CZM) and gatekeepers can consider the needs of people with LD within coastal strategies. Finally, this research also highlighted the use of photovoice in coastal research projects and the need for innovative methodological considerations when researching certain groups

Serenity Integrated Mentoring and the High Intensity Network: a scheme that raises serious questions for practice and governance in UK psychiatry

Serenity Integrated Mentoring (SIM) involved the police and mental health crisis services working in a single team, developing case management plans that allowed a seamless move from offers of therapeutic engagement (by the mental health team) to use of coercive measures (by the police) with those who persisted with frequent crisis presentations. Withdrawn after widespread criticism, the scheme raises important questions – about the practice of mental health professionals who are involved in decisions about using criminal sanctions for people presenting in crisis, about the ethical and legal status of the sharing of confidential clinical information with the police, and about the processes that professional bodies use in promoting, monitoring and responding to controversial service developments

In situ generation of Mes2Mg as a non-nucleophilic carbon-centred base reagent for the efficient one-pot conversion of ketones to silyl enol ethers

Treatment of commercially available MesMgBr with 1,4-dioxane produces the key Mes2Mg reagent in situ which then mediates the deprotonation of ketones to deliver trimethylsilyl enol ethers, at readily accessible temperatures and without any nucleophilic addition, in an expedient and high yielding one-pot process

A feasibility study of a brief psycho-educational intervention for psychogenic nonepileptic seizures

AbstractPurposeWe have previously reported that one in six patients stops experiencing psychogenic nonepileptic seizures (PNES) following our communication protocol. This prospective multicentre study describes a psycho-educational intervention for PNES building on the initial communication of the diagnosis and examines the feasibility of its delivery by healthcare professionals with minimal experience in psychological therapies.MethodThree healthcare professionals with minimal training in psychological therapies took part in a one-day training course. 20 participants attended for a four-session manualised psycho-educational intervention delivered at three different clinical neuroscience centres. Participants completed self-report measures prior to the intervention at baseline (n=29) and seven months after diagnosis (n=13) measures included seizure frequency, health related quality of life, healthcare utilisation, activity levels, symptom attributions and levels of functioning. Therapy sessions were audiorecorded and manual adherence assessed.ResultsOf 29 patients enrolled into the study, 20 started and 13 completed the intervention and provided follow-up information. At follow-up, 4/13 of patients had achieved complete seizure control and a further 3/13 reported a greater than 50% improvement in seizure frequency. After training, epilepsy nurses and assistant psychologists demonstrated sufficient adherence to the manualised psycho-educational intervention in 80% of sessions.ConclusionThe delivery of our brief manualised psycho-educational intervention for PNES by health professionals with minimal training in psychological treatment was feasible. The intervention was associated with higher rates of PNES cessation than those observed in our previous studies describing the short-term outcome of the communication of the diagnosis alone. An RCT of the intervention is justified but a significant proportion of drop-outs will have to be anticipated

Investigation of Rifting Processes in the Rio Grande Rift Using Data from Unusually Large Earthquake Swarms

San Acacia Swarm in the Rio Grande Rift. Because the Rio Grande rift is one of the best seismically instrumented rift zones in the world, studying its seismicity provides an exceptional opportunity to explore the active tectonic processes within continental rifts. We have been studying earthquake swarms recorded near Socorro in an effort to link seismicity directly to the rifting process. For FY94, our research has focused on the San Acacia swarm, which occurred 25 km north of Socorro, New Mexico, along the accommodation zone between the Albuquerque-Belen and Socorro basins of the central Rio Grande rift. The swarm commenced on 25 February 1983, had a magnitude 4.2 main shock on 2 March and ended on 17 March, 1983

Post stroke intervention trial in fatigue (POSITIF):Randomised multicentre feasibility trial

OBJECTIVE: To test the feasibility of a telephone delivered intervention, informed by cognitive behavioural principles, for post-stroke fatigue, and estimated its effect on fatigue and other outcomes. DESIGN: Randomised controlled parallel group trial. SETTING: Three Scottish stroke services. SUBJECTS: Stroke survivors with fatigue three months to two years post-stroke onset. INTERVENTIONS: Seven telephone calls (fortnightly then a ‘booster session’ at 16 weeks) of a manualised intervention, plus information about fatigue, versus information only. MAIN MEASURES: Feasibility of trial methods, and collected outcome measures (fatigue, mood, anxiety, social participation, quality of life, return to work) just before randomisation, at the end of treatment (four months after randomisation) and at six months after randomisation. RESULTS: Between October 2018 and January 2020, we invited 886 stroke survivors to participate in postal screening: 188/886 (21%) returned questionnaires and consented, of whom 76/188 (40%) were eligible and returned baseline forms; 64/76 (84%) returned six month follow-up questionnaires. Of the 39 allocated the intervention, 23 (59%) attended at least four sessions. At six months, there were no significant differences between the groups (adjusted mean differences in Fatigue Assessment Scale −0.619 (95% CI −4.9631, 3.694; p = 0.768), the Generalised Anxiety Disorder 7 −0.178 (95% CI −3.823, 3.467, p = 0.92), and the Patient Health Questionnaire −0.247 (95% CI −2.935, 2.442, p = 0.851). There were no between-group differences in quality of life, social participation or return to work. CONCLUSION: Patients can be recruited to a trial of this design. These data will inform the design of further trials in post-stroke fatigue

Advocacy in the tail: Exploring the implications of ‘climategate’ for science journalism and public debate in the digital age

This paper explores the evolving practices of science journalism and public debate in the digital age. The vehicle for this study is the release of digitally stored email correspondence, data and documents from the Climatic Research Unit at the University of East Anglia in the weeks immediately prior to the United Nations Copenhagen Summit (COP-15) in December 2009. Described using the journalistic shorthand of ‘climategate’, and initially promoted through socio-technical networks of bloggers, this episode became a global news story and the subject of several formal reviews. ‘Climategate’ illustrates that media literate critics of anthropogenic explanations of climate change used digital tools to support their cause, making visible selected, newsworthy aspects of scientific information and the practices of scientists. In conclusion, I argue that ‘climategate’ may have profound implications for the production and distribution of science news, and how climate science is represented and debated in the digitally-mediated public sphere