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Understanding the barriers to accessing symptom-specific cognitive behavior therapy (CBT) for distressing voices: reflecting on and extending the lessons learnt from the CBT for psychosis literature

The experience of hearing voices ('auditory hallucinations') can cause significant distress and disruption to quality of life for people with a psychosis diagnosis. Psychological therapy in the form of Cognitive Behavior Therapy for psychosis is recommended for the treatment of positive symptoms, including distressing voices, but is rarely available to patients in the UK. Cognitive Behavior Therapy for psychosis has recently evolved with the development of symptom-specific therapies that focus upon only one symptom of psychosis at a time. Preliminary findings from randomized controlled trials suggest that these symptom-specific therapies can be more effective for distressing voices than the use of broad CBT protocols, and have the potential to target voices trans-diagnostically. Whilst this literature is evolving, consideration must be given to the potential for a symptom-specific approach to overcome some of the barriers to delivery of evidence-based psychological therapies within clinical services. These barriers are discussed in relation to the UK mental health services, and we offer suggestions for future research to enhance our understanding of these barriers

Tributes to Professor Alice Brumbaugh

Tributes to Professor Alice Brumbaugh upon her retirement from the University of Maryland School of Law

Encouraging versatile thinking in algebra using the computer

In this article we formulate and analyse some of the obstacles to understanding the notion of a variable, and the use and meaning of algebraic notation, and report empirical evidence to support the hypothesis that an approach using the computer will be more successful in overcoming these obstacles. The computer approach is formulated within a wider framework ofversatile thinking in which global, holistic processing complements local, sequential processing. This is done through a combination of programming in BASIC, physical activities which simulate computer storage and manipulation of variables, and specific software which evaluates expressions in standard mathematical notation. The software is designed to enable the user to explore examples and non-examples of a concept, in this case equivalent and non-equivalent expressions. We call such a piece of software ageneric organizer because if offers examples and non-examples which may be seen not just in specific terms, but as typical, or generic, examples of the algebraic processes, assisting the pupil in the difficult task of abstracting the more general concept which they represent. Empirical evidence from several related studies shows that such an approach significantly improves the understanding of higher order concepts in algebra, and that any initial loss in manipulative facility through lack of practice is more than made up at a later stage

Housing insecurity, housing conditions, and breastfeeding behaviors for medicaid-eligible families in urban settings

BACKGROUND: Research exploring associations between exposure to social determinants of health and breastfeeding is needed to identify breastfeeding barriers. Housing insecurity and household conditions (chaos and crowding) may affect breastfeeding by increasing maternal stress and discomfort and decreasing time available to breastfeed. RESEARCH AIM: We aimed to examine the relationships between housing insecurity, breastfeeding exclusivity intention during the early postnatal period, and breastfeeding exclusivity at 6 months postpartum among a sample "at risk" for suboptimal breastfeeding rates. METHODS: This study is a secondary data analysis of a longitudinal study at two time periods. Data were collected from English- and Spanish-speaking, Medicaid-eligible mother-infant dyads (N = 361) at near-birth and child aged 6 months, in New York City and Pittsburgh. Structural equation modeling was used to examine direct and indirect effects of housing insecurity on breastfeeding exclusivity at child aged 6 months. RESULTS: The path model showed that experiencing more markers of housing insecurity (i.e., foreclosure/eviction threat, history of homelessness, late rent) was predictive of significantly lower breastfeeding exclusivity at 6 months. This was partially mediated through less exclusive breastfeeding intention during the early postnatal period. Greater household crowding was associated with 6-month breastfeeding exclusivity when mediated by intention. Household crowding had differential effects by study site and participant race/ethnicity. CONCLUSION: Refinement of housing insecurity as a multi-dimensional construct can lead to the development of standardized data collection instruments, inform future methodological decisions in research addressing social determinants of health, and can inform the development of responsive individual- and structural-level interventions.The data used in this study were collected as part of the SMART Beginnings Randomized Controlled Trial (NCT02459327 registered at ClinicalTrials.gov)

In vitro antiviral activity of SCH446211 (SCH6), a novel inhibitor of the hepatitis C virus NS3 serine protease.

Current hepatitis C virus (HCV) therapies may cure approximately 60% of infections. They are often contraindicated or poorly tolerated, underscoring the need for safer and more effective drugs. A novel, alpha-ketoamide-derived, substrate-based inhibitor of the HCV serine protease (SCH446211) was developed. Compared with earlier reported inhibitors of similar chemical class, it has a P1'-P2' extension which provides extended interaction with the protease active site. The aim of this study was to evaluate the in vitro antiviral activity of SCH446211. Binding constant of SCH446211 to HCV NS3 protease was measured with the chromogenic substrate in vitro cleavage assay. Cell-based activity of SCH446211 was evaluated in replicon cells, which are Huh-7 hepatoma cells stably transfected with a subgenomic HCV RNA as reported previously. After 72 h of incubation with SCH446211, viral transcription and protein expression were measured by real-time RT-PCR (TaqMan), quantitative in situ hybridization, immunoblot and indirect immunofluorescence. The binding constant of SCH446211 to HCV NS3 protease was 3.8 +/- 0.4 nM. HCV replication and protein expression were inhibited by SCH446211 in replicon cells as consistently shown by four techniques. In particular, based on quantitative real-time RT-PCR measurements, the IC50 and IC90 of SCH446211 were estimated to be 40 +/- 20 and 100 +/- 20 nM (n = 17), respectively. Long-term culture of replicon cells with SCH446211 reduced replicon RNA to <0.1 copy per cell. SCH446211 did not show cellular toxicity at concentrations up to 50 microM. SCH446211 is a potent inhibitor of HCV protease in vitro. Its extended interaction with the HCV NS3 protease active site is associated with potent in vitro antiviral activity. This observation is potentially a useful guide for development of future potent inhibitors against HCV NS3 protease

Prototype Near-Field/GIS Model for Sequestered-CO2 Risk Characterization and Management

Detecting unmapped abandoned wells thus remains a major carbon sequestration (CS) technology gap. Many (>10{sup 5}) abandoned wells are thought to lie in potential sequestration sites. For such wells, risk analysis to date has focused on aggregate long-term future impacts of seepage at rates < or << {approx}1 g m{sup 2} d{sup -1} on storage goals as sequestered plumes encroach upon wells with assumed distributions of seal ineffectiveness (Oldenburg and Unger, 2003; Saripali et al. 2003; Celia, 2005). However, unmapped abandoned wells include an unknown number without any effective seal at all, venting through which may dominate CO{sub 2}-loss scenarios. A model of such a well is Crystal Geyser (CG), a prospective oil well abandoned in the 1930s with no barrier installed after it encountered a natural CO{sub 2} reservoir rather than oil (Baer and Rigby, 1978; Rinehart, 1980). CG demonstrates how an unimpeded conduit to the surface now regularly vents from 10{sup 3} to >10{sup 4} kg of CO{sub 2} gas to the terrestrial surface (Figure 1). Unique field data recently gathered from Crystal Geyser (CG) in Utah (Gouveia et al. 2005) confirm that, although resulting surface CO{sub 2} concentrations resulting from CG-like eruptions would likely be safe in general, they could accumulate to pose lethal hazards under relatively rare meteorological and topographic (MT) conditions. This source of foreseeable risk needs to be managed if carbon sequestration is to be publicly accepted. To address this concern, we used CG field data to estimate the source term for a prototype model that identifies zones at relatively highly elevated risk for sequestered-CO{sub 2} casualties. Such a model could be applied both to design and comply with future regulatory requirements to survey high-risk zones in each proposed sequestration site for improperly sealed wells

Articles of Faith: Freedom of Expression and Religious Freedom in Contemporary Multiculture

This article examines the relationship between freedom of religion and freedom of speech and expression within contemporary multicultural liberal democracies. These two fundamental human rights have increasingly been seen, in public and political discourse, in terms of tension if not outright opposition, a view reinforced by the Charlie Hebdo killings in January 2015. And yet in every human rights charter they are proximate to one another. This essay argues that this adjacency is not coincidental, that it has a history and that, in illuminating this history, it is possible to explore how the contemporary framing of these two rights as being in opposition has come about. Looking back to the framing of the First Amendment of the US Constitution, the essay offers an historical perspective that, in turn, facilitates a reappraisal and re-evaluation of these two liberties that is the necessary, albeit insufficient, predicate to the task of addressing the problematic of multicultural ‘crisis' in the contemporary liberal democracies of Western Europe, North America and Australasia, in which the presence of certain religious communities (Muslims, in particular) and the role of religion in public and political life more generally (and, conversely, of secularism) has assumed a central importance