Beyond Black Uniforms and Withered Victims: Exploring Individual Decision-Making in Democratic Kampuchea, 1975-1979

Master'sMASTER OF ART

Localisation d'agents mobiles physiques

Une fonctionnalité intéressante pour des robots opérant au sein d'un groupe est d'arriver à déterminer la position des autres robots du groupe. L'objectif du projet est de concevoir un dispositif permettant à des robots de se localiser sans utiliser de balises ou de références extérieures, dans un rayon de 5 à 10 mètres. Ce dispositif doit permettre aux robots de se reconnaître et de se localiser directement les uns par rapport aux autres, être peu dispendieux, facile à installer sur à peu près n'importe quels robots et être le plus indépendant possible du nombre d'agents physiques mobiles à localiser. L'approche retenue consiste à utiliser plusieurs récepteurs sur un même agent mobile pour détecter une onde transmise par un autre agent mobile. L'information recueillie, qui est liée au temps d'arrivée de l'onde, est ensuite utilisée pour déterminer la position du transmetteur par rapport aux récepteurs. Deux approches sont étudiées: la première, utilisant des ondes électromagnétiques, s'est avérée difficile à mettre en oeuvre alors que la seconde, utilisant des ondes ultrasoniques, a donné des résultats extrêmement encourageants. Le système ultrasonique permet la localisation dans un rayon de 8,1 m avec une erreur absolue moyenne de 3,75 mm sur la distance et de 1,84 degrés sur l'angle. Le dispositif a permis à deux robots de se déplacer avec succès dans une configuration meneur-suiveur

Evidence-based prescribing for post-traumatic stress disorder

There is strong research evidence to support the pharmacological treatment of post-traumatic stress disorder (PTSD) as a second line to trauma-focused psychological interventions. Fluoxetine, paroxetine, sertraline and venlafaxine are the best-evidenced drugs, with lower-level evidence for other medications. It is important that prescribing for PTSD is evidence-based

A systematic review of factors associated with outcome of psychological treatments for post-traumatic stress disorder

Objective: Psychological interventions for post-traumatic stress disorder (PTSD) are not always effective and can leave some individuals with enduring symptoms. Little is known about factors that are associated with better or worse treatment outcome. Our objective was to address this gap. Method: We undertook a systematic review following Cochrane Collaboration Guidelines. We included 126 randomized controlled trials (RCTs) of psychological interventions for PTSD and examined factors that were associated with treatment outcome, in terms of severity of PTSD symptoms post-treatment, and recovery or remission. Results: Associations were neither consistent nor strong. Two factors were associated with smaller reductions in severity of PTSD symptoms post-treatment: comorbid diagnosis of depression, and higher PTSD symptom severity at baseline assessment. Higher education, adherence to homework and experience of a more recent trauma were associated with better treatment outcome. Conclusion: Identifying and understanding why certain factors are associated with treatment outcome is vital to determine which individuals are most likely to benefit from particular treatments and to develop more effective treatments in the future. There is an urgent need for consistent and standardized reporting of factors associated with treatment outcome in all clinical trials

Managing the risk of post-traumatic stress disorder (PTSD): best practice for prevention, detection and treatment

In this issue, Bonde and colleagues1 present a comprehensive systematic review of the time course of symptoms in post-traumatic stress disorder (PTSD) with delayed expression. Finding that in most cases PTSD is preceded by traumatic stress symptoms during the first year, they conclude a need to monitor traumatic stress symptoms after trauma exposure to identify those at risk of developing PTSD. This work draws attention to the prevalence of traumatic stress symptoms after trauma exposure, as well as indicating the potential to identify those likely to develop PTSD at a later point in time based on earlier symptoms. This indicates the value of revisiting what we know about best practice in managing the risk of PTSD

Managing COVID-19 related distress in primary care:principles of assessment and management

COVID-19 will cause normal feelings of worry and stress and many of those who experience higher levels of distress will experience resolution of their symptoms as society returns to pre-COVID-19 functioning. Only a minority are likely to develop a psychiatric disorder. Certain individuals may be vulnerable to experiencing persisting symptoms, such as those with pre-existing comorbidity. Management approaches could centre around using collaborative approaches to provide and build on already existing socioeconomic support structures, the avoidance of over-medicalisation, watchful waiting and finally treating those who do meet the criteria for psychiatric diagnosis. Primary care clinicians are likely be the first healthcare point of contact for most COVID-19 related distress and it is important that they are able to provide evidence based and evidence informed responses, which includes social, psychological and pharmacological approaches. This expert opinion paper serves to summarise some approaches, based primarily on indirect extrapolation of evidence concerning the general management of psychological distress, in the absence of COVID-19 specific evidence, to assist primary care clinicians in their assessment and management of COVID-19 related distress

Active duty and ex-serving military personnel with post-traumatic stress disorder treated with psychological therapies: systematic review and meta-analysis

Background: Post-traumatic stress disorder (PTSD) is a major cause of morbidity amongst active duty and ex-serving military personnel. In recent years increasing efforts have been made to develop more effective treatments. Objective: To determine which psychological therapies are efficacious in treating active duty and ex-serving military personnel with post-traumatic stress disorder (PTSD). Method: A systematic review was undertaken according to Cochrane Collaboration Guidelines. The primary outcome measure was reduction in PTSD symptoms and the secondary outcome dropout. Results: Twenty-four studies with 2386 participants were included. Evidence demonstrated that CBT with a trauma focus (CBT-TF) was associated with the largest evidence of effect when compared to waitlist/usual care in reducing PTSD symptoms post treatment (10 studies; n = 524; SMD −1.22, −1.78 to −0.66). Group CBT-TF was less effective when compared to individual CBT-TF at reducing PTSD symptoms post treatment (1 study; n = 268; SMD −0.35, −0.11 to −0.59). Eye Movement Desensitization and Reprocessing (EMDR) therapy was not effective when compared to waitlist/usual care at reducing PTSD symptoms post treatment (4 studies; n = 92; SMD −0.83, −1.75 to 0.10). There was evidence of greater dropout from CBT-TF therapies compared to waitlist and Present Centred Therapy. Conclusions: The evidence, albeit limited, supports individual CBT-TF as the first-line psychological treatment of PTSD in active duty and ex-serving personnel. There is evidence for Group CBT-TF, but this is not as strong as for individual CBT-TF. EMDR cannot be recommended as a first line therapy at present and urgently requires further evaluation. Lower effect sizes than for other populations with PTSD and high levels of drop-out suggest that CBT-TF in its current formats is not optimally acceptable and further research is required to develop and evaluate more effective treatments for PTSD and complex PTSD in active duty and ex-serving military personnel

Non-pharmacological and non-psychological approaches to the treatment of PTSD: results of a systematic review and meta-analyses

ABSTRACT Background: Non-pharmacological and non-psychological approaches to the treatment of post-traumatic stress disorder (PTSD) have often been excluded from systematic reviews and meta-analyses. Consequently, we know little regarding their efficacy. Objective: To determine the effect sizes of non-pharmacological and non-psychological treatment approaches for PTSD. Method: We undertook a systematic review and meta-analyses following Cochrane Collaboration guidelines. A pre-determined definition of clinical importance was applied to the results and the quality of evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Results: 30 randomised controlled trials (RCTs) of a range of heterogeneous non- psychological and non-pharmacological interventions (28 in adults, two in children and adolescents) were included. There was emerging evidence for six different approaches (acupuncture, neurofeedback, saikokeishikankyoto (a herbal preparation), somatic experiencing, transcranial magnetic stimulation, and yoga). Conclusions: Given the level of evidence available, it would be premature to offer non- pharmacological and non-psychological interventions routinely, but those with evidence of efficacy provide alternatives for people who do not respond to, do not tolerate or do not want more conventional evidence-based interventions. This review should stimulate further research in this area