Clinical outcomes from The BodyMind Approach™ in the treatment of patients with medically unexplained symptoms in primary health care in England: practice-based evidence

This is the accepted manuscript version of the following article: Helen Payne and Susan D. M. Brooks, ‘Clinical outcomes from The BodyMind Approach™ in the treatment of patients with medically unexplained symptoms in primary health care in England: Practice-based evidence’, The Arts in Psychotherapy, Vol 47: 55-65, February 2016, doi: http://dx.doi.org/10.1016/j.aip.2015.12.001. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/.This article builds on Payne (2015) and reports on practice–based evidence arising out of the delivery of a new and innovative service using The BodyMind Approach™ (TBMA) for the treatment of patients with medically unexplained symptoms (MUS) in primary care in the National Health Service (NHS) in Hertfordshire, a county near London, England, in the UK. The analysis of data collected for three groups (N=16) over 18 months used standardised assessment tools and other relevant information at pre, post and at a six month follow up. The outcomes for patients in this small scale piece of practice based evidence indicated that there were reductions in symptom distress, anxiety and depression, increased overall wellbeing and improvement in activity levels. Patients developed self-management of their symptoms through understanding, acceptance and coping strategies. The increased knowledge, exchange of experiences together with understanding and acceptance from others promoted a sense of wellbeing. Thus, the programme was experienced to be a beneficial intervention. In addition to the clinical outcomes reported here there are other benefits for NHS England for example, savings on medication and referral costs and General Practitioner (GP) capacity enhanced. The clinical service is based on previous research conducted by Payne and Stott (2010). This article focusses solely on the analysis and interpretation of clinical outcomes from the practice-based evidence. Keywords: The BodyMind Approach™; medically unexplained symptoms; primary care; practice-based evidence IntroductionPeer reviewedFinal Accepted Versio

Naval Ship Maintenance: An Analysis of the Dutch Shipbuilding Industry Using the Knowledge Value Added, Systems Dynamics, and Integrated Risk Management Methodologies

Sponsored Report (for Acquisition Research Program)Initiatives to reduce the cost of ship maintenance have not yet realized the normal cost-reduction learning curve improvements. One explanation is the lack of recommended technologies. Damen, a Dutch shipbuilding and service firm, has incorporated similar technologies and is developing others to improve its operations. The research team collected data on Dutch ship maintenance operations and used them to build three types of computer simulation models of ship maintenance and technology adoption. The results were analyzed and compared with previously developed modeling results of U.S. Navy ship maintenance and technology adoption. Adopting 3D PDF alone improves ROI significantly more than adopting a logistics package alone and adding both technologies improves ROI more than adding either technology alone. Adoption of the technologies would provide cost benefits far in excess of not using the technologies and there were marginal benefits in sequentially implementing the technologies over immediately implementing them. There are a number of issues in comparing the results with previous research but the potential benefits of using the technologies are very high in both cases. Implications for acquisition practice include the need for careful analysis and selection from among a variety of available information technologies and the recommendation for a phased development and implementation approach to manage uncertainty.Acquisition Research Progra

Identifying genotype specific elevated-risk areas and associated herd risk factors for bovine tuberculosis spread in British cattle

Bovine tuberculosis (bTB) is a chronic zoonosis with major health and economic impact on the cattle industry. Despite extensive control measures in cattle and culling trials in wildlife, the reasons behind the expansion of areas with high incidence of bTB breakdowns in Great Britain remain unexplained. By balancing the importance of cattle movements and local transmission on the observed pattern of cattle outbreaks, we identify areas at elevated risk of infection from specific Mycobacterium bovis genotypes. We show that elevated-risk areas (ERAs) were historically more extensive than previously understood, and that cattle movements alone are insufficient for ERA spread, suggesting the involvement of other factors. For all genotypes, we find that, while the absolute risk of infection is higher in ERAs compared to areas with intermittent risk, the statistically significant risk factors are remarkably similar in both, suggesting that these risk factors can be used to identify incipient ERAs before this is indicated by elevated incidence alone. Our findings identify research priorities for understanding bTB dynamics, improving surveillance and guiding management to prevent further ERA expansion

Estimation of solar prominence magnetic fields based on the reconstructed 3D trajectories of prominence knots

We present an estimation of the lower limits of local magnetic fields in quiescent, activated, and active (surges) promineces, based on reconstructed 3-dimensional (3D) trajectories of individual prominence knots. The 3D trajectories, velocities, tangential and centripetal accelerations of the knots were reconstructed using observational data collected with a single ground-based telescope equipped with a Multi-channel Subtractive Double Pass imaging spectrograph. Lower limits of magnetic fields channeling observed plasma flows were estimated under assumption of the equipartition principle. Assuming approximate electron densities of the plasma n_e = 5*10^{11} cm^{-3} in surges and n_e = 5*10^{10} cm^{-3} in quiescent/activated prominences, we found that the magnetic fields channeling two observed surges range from 16 to 40 Gauss, while in quiescent and activated prominences they were less than 10 Gauss. Our results are consistent with previous detections of weak local magnetic fields in the solar prominences.Comment: 14 pages, 12 figures, 1 tabl

Search for the Proton Decay Mode proton to neutrino K+ in Soudan 2

We have searched for the proton decay mode proton to neutrino K+ using the one-kiloton Soudan 2 high resolution calorimeter. Contained events obtained from a 3.56 kiloton-year fiducial exposure through June 1997 are examined for occurrence of a visible K+ track which decays at rest into mu+ nu or pi+ pi0. We found one candidate event consistent with background, yielding a limit, tau/B > 4.3 10^{31} years at 90% CL with no background subtraction.Comment: 13 pages, Latex, 3 tables and 3 figures, Accepted by Physics Letters

Signatures of the slow solar wind streams from active regions in the inner corona

Some of local sources of the slow solar wind can be associated with spectroscopically detected plasma outflows at edges of active regions accompanied with specific signatures in the inner corona. The EUV telescopes (e.g. SPIRIT/CORONAS-F, TESIS/CORONAS-Photon and SWAP/PROBA2) sometimes observed extended ray-like structures seen at the limb above active regions in 1MK iron emission lines and described as "coronal rays". To verify the relationship between coronal rays and plasma outflows, we analyze an isolated active region (AR) adjacent to small coronal hole (CH) observed by different EUV instruments in the end of July - beginning of August 2009. On August 1 EIS revealed in the AR two compact outflows with the Doppler velocities V =10-30 km/s accompanied with fan loops diverging from their regions. At the limb the ARCH interface region produced coronal rays observed by EUVI/STEREO-A on July 31 as well as by TESIS on August 7. The rays were co-aligned with open magnetic field lines expanded to the streamer stalks. Using the DEM analysis, it was found that the fan loops diverged from the outflow regions had the dominant temperature of ~1 MK, which is similar to that of the outgoing plasma streams. Parameters of the solar wind measured by STEREO-B, ACE, WIND, STEREO-A were conformed with identification of the ARCH as a source region at the Wang-Sheeley-Arge map of derived coronal holes for CR 2086. The results of the study support the suggestion that coronal rays can represent signatures of outflows from ARs propagating in the inner corona along open field lines into the heliosphere.Comment: Accepted for publication in Solar Physics; 31 Pages; 13 Figure

An Integrated TCGA Pan-Cancer Clinical Data Resource to Drive High-Quality Survival Outcome Analytics

For a decade, The Cancer Genome Atlas (TCGA) program collected clinicopathologic annotation data along with multi-platform molecular profiles of more than 11,000 human tumors across 33 different cancer types. TCGA clinical data contain key features representing the democratized nature of the data collection process. To ensure proper use of this large clinical dataset associated with genomic features, we developed a standardized dataset named the TCGA Pan-Cancer Clinical Data Resource (TCGA-CDR), which includes four major clinical outcome endpoints. In addition to detailing major challenges and statistical limitations encountered during the effort of integrating the acquired clinical data, we present a summary that includes endpoint usage recommendations for each cancer type. These TCGA-CDR findings appear to be consistent with cancer genomics studies independent of the TCGA effort and provide opportunities for investigating cancer biology using clinical correlates at an unprecedented scale. Analysis of clinicopathologic annotations for over 11,000 cancer patients in the TCGA program leads to the generation of TCGA Clinical Data Resource, which provides recommendations of clinical outcome endpoint usage for 33 cancer types

Inclusive cross section and double helicity asymmetry for \pi^0 production in p+p collisions at sqrt(s)=200 GeV: Implications for the polarized gluon distribution in the proton

The PHENIX experiment presents results from the RHIC 2005 run with polarized proton collisions at sqrt(s)=200 GeV, for inclusive \pi^0 production at mid-rapidity. Unpolarized cross section results are given for transverse momenta p_T=0.5 to 20 GeV/c, extending the range of published data to both lower and higher p_T. The cross section is described well for p_T < 1 GeV/c by an exponential in p_T, and, for p_T > 2 GeV/c, by perturbative QCD. Double helicity asymmetries A_LL are presented based on a factor of five improvement in uncertainties as compared to previously published results, due to both an improved beam polarization of 50%, and to higher integrated luminosity. These measurements are sensitive to the gluon polarization in the proton, and exclude maximal values for the gluon polarization.Comment: 375 authors, 7 pages, 3 figures. Submitted to Phys. Rev. D, Rapid Communications. Plain text data tables for the points plotted in figures for this and previous PHENIX publications are (or will be) publicly available at http://www.phenix.bnl.gov/papers.htm

Search for direct production of charginos and neutralinos in events with three leptons and missing transverse momentum in √s = 7 TeV pp collisions with the ATLAS detector

A search for the direct production of charginos and neutralinos in final states with three electrons or muons and missing transverse momentum is presented. The analysis is based on 4.7 fb−1 of proton–proton collision data delivered by the Large Hadron Collider and recorded with the ATLAS detector. Observations are consistent with Standard Model expectations in three signal regions that are either depleted or enriched in Z-boson decays. Upper limits at 95% confidence level are set in R-parity conserving phenomenological minimal supersymmetric models and in simplified models, significantly extending previous results