Effect of mindfulness based relapse prevention on developmental trends, stress, and substance use among young adults in residential substance use treatment: a randomized controlled trial

Substance use, stress, and early childhood trauma are among the most detrimental catalysts for chronic psychological, behavioral and health related problems. The Institute of Medicine recently released a report on the health and well-being of emerging adults, calling for a more comprehensive investigation of the risks, health, safety, and development of marginalized emerging adults. In a recent meta-analysis on mindfulness based interventions for substance use disorders only one study utilized an emerging adult population – however this study recruited college attending emerging adults. While important, no study has assessed the efficacy of mindfulness based relapse prevention (MBRP) with a sample of emerging adults recruited from a not for profit treatment facility. The current study used a randomized controlled design to assign individuals (N = 79) to receive MBRP or treatment as usual (TAU). Participants were followed for six months with assessments occurring on a bi-monthly basis (two week intervals). At each time point we measured substance use, craving, and stress. Results indicated significant decreases in substance use, stress, and craving for individuals assigned to MBRP versus TAU. Further, mediation models revealed a significant indirect effect for reductions in stress during the treatment phase and both substance use and craving during the post-treatment phase. This study provides further support for the use of mindfulness based interventions and is the first to investigate its utility among a sample of marginalized emerging adults. Further, this study provides support for reductions in perceived stress to act as a mechanism between reductions in both substance use and craving

There to help: ensuring provision of appropriate adults for mentally vulnerable adults detained or interviewed by police

Abstract Background Stroke patients requiring decompressive craniectomy are at high risk of prolonged mechanical ventilation and ventilator-associated pneumonia (VAP). Tracheostomy placement may reduce the duration of mechanical ventilation. Predicting which patients will require tracheostomy and the optimal timing of tracheostomy remains a clinical challenge. In this study, the authors compare key outcomes after early versus late tracheostomy and develop a useful pre-operative decision-making tool to predict post-operative tracheostomy dependence. Methods We performed a retrospective analysis of prospectively collected registry data. We developed a propensity-weighted decision tree analysis to predict tracheostomy requirement using factors present prior to surgical decompression. In addition, outcomes include probability functions for intensive care unit length of stay, hospital length of stay, and mortality, based on data for early (≤ 10 days) versus late (> 10 days) tracheostomy. Results There were 168 surgical decompressions performed on patients with acute ischemic or spontaneous hemorrhagic stroke between 2010 and 2015. Forty-eight patients (28.5%) required a tracheostomy, 35 (20.8%) developed VAP, and 126 (75%) survived hospitalization. Mean ICU and hospital length of stay were 15.1 and 25.8 days, respectively. Using GCS, SOFA score, and presence of hydrocephalus, our decision tree analysis had 63% sensitivity and 84% specificity for predicting tracheostomy requirement. The early group had fewer ventilator days (7.3 versus 15.2, p < 0.001) and shorter hospital length of stay (28.5 versus 44.4 days, p = 0.014). VAP rates and mortality were similar between the two groups. Withdrawal of treatment interventions shortly post-operatively confounded mortality outcomes. Conclusion Early tracheostomy shortens duration of mechanical ventilation and length of stay after surgical decompression for stroke, but it did not impact mortality or VAP rates. A decision tree is a practical tool that may be helpful in guiding pre-operative decision-making with patients’ families

Theory and numerical modeling of electrical self-potential signatures of unsaturated flow in melting snow

We have developed a new theory and numerical model of electrical self-potential (SP) signals associated with unsaturated flow in melting snow. The model is applicable to continuous natural-melt and transient-flow phenomena such as melt-water pulses, and is tested using laboratory column experiments. SP signals fundamentally depend on the temporal evolution of snow porosity and melt-water flux, electrical conductivity (EC) and pH. We infer a reversal of the sign of the zeta potential (a fundamental electrical property of grain surfaces in porous media), consistent with well-known elution sequences of ions that cause progressive increases and decreases in melt-water pH and EC respectively. Injection of fully-melted snow samples, containing the entire natural range of ions, into melting snow columns caused additional temporary reversals of the sign of the zeta potential. Widely-used empirical relationships between effective saturation, melt-water fraction, EC and pH, as well as snow porosity, grain size and permeability are found to be robust for modelling purposes. Thus, non-intrusive SP measurements can serve as proxies for snow melt-water fluxes and the temporal evolution of fundamental snow textural, hydraulic or water-quality parameters. Adaptation of automated multi-sensor SP acquisition technology from other environmental applications thus promises to bridge the widely acknowledged gap in spatial scale between satellite remote sensing and point measurements of snow properties. SP measurements and modelling may therefore contribute to solving a wide range of problems related to the assessment of water resource availability, avalanche or flood risk, or amplification of climatic forcing of ice-shelf, ice-sheet or glacier dynamics

Changes in fish assemblages following the establishment of a network of no-take marine reserves and partially-protected areas

Networks of no-take marine reserves and partially-protected areas (with limited fishing) are being increasingly promoted as a means of conserving biodiversity. We examined changes in fish assemblages across a network of marine reserves and two different types of partially-protected areas within a marine park over the first 5 years of its establishment. We used Baited Remote Underwater Video (BRUV) to quantify fish communities on rocky reefs at 20-40 m depth between 2008-2011. Each year, we sampled 12 sites in 6 no-take marine reserves and 12 sites in two types of partially-protected areas with contrasting levels of protection (n = 4 BRUV stations per site). Fish abundances were 38% greater across the network of marine reserves compared to the partially-protected areas, although not all individual reserves performed equally. Compliance actions were positively associated with marine reserve responses, while reserve size had no apparent relationship with reserve performance after 5 years. The richness and abundance of fishes did not consistently differ between the two types of partially-protected areas. There was, therefore, no evidence that the more regulated partially-protected areas had additional conservation benefits for reef fish assemblages. Overall, our results demonstrate conservation benefits to fish assemblages from a newly established network of temperate marine reserves. They also show that ecological monitoring can contribute to adaptive management of newly established marine reserve networks, but the extent of this contribution is limited by the rate of change in marine communities in response to protection

Contemporary medical television and crisis in the NHS

This article maps the terrain of contemporary UK medical television, paying particular attention to Call the Midwife as its centrepiece, and situating it in contextual relation to the current crisis in the NHS. It provides a historical overview of UK and US medical television, illustrating how medical television today has been shaped by noteworthy antecedents. It argues that crisis rhetoric surrounding healthcare leading up to the passing of the Health and Social Care Act 2012 has been accompanied by a renaissance in medical television. And that issues, strands and clusters have emerged in forms, registers and modes with noticeable regularity, especially around the value of affective labour, the cultural politics of nostalgia and the neoliberalisation of healthcare

Schrieffer-Wolff transformation for quantum many-body systems

The Schrieffer-Wolff (SW) method is a version of degenerate perturbation theory in which the low-energy effective Hamiltonian H_{eff} is obtained from the exact Hamiltonian by a unitary transformation decoupling the low-energy and high-energy subspaces. We give a self-contained summary of the SW method with a focus on rigorous results. We begin with an exact definition of the SW transformation in terms of the so-called direct rotation between linear subspaces. From this we obtain elementary proofs of several important properties of H_{eff} such as the linked cluster theorem. We then study the perturbative version of the SW transformation obtained from a Taylor series representation of the direct rotation. Our perturbative approach provides a systematic diagram technique for computing high-order corrections to H_{eff}. We then specialize the SW method to quantum spin lattices with short-range interactions. We establish unitary equivalence between effective low-energy Hamiltonians obtained using two different versions of the SW method studied in the literature. Finally, we derive an upper bound on the precision up to which the ground state energy of the n-th order effective Hamiltonian approximates the exact ground state energy.Comment: 47 pages, 3 figure

Genome-Wide Requirements for Resistance to Functionally Distinct DNA-Damaging Agents

The mechanistic and therapeutic differences in the cellular response to DNA-damaging compounds are not completely understood, despite intense study. To expand our knowledge of DNA damage, we assayed the effects of 12 closely related DNA-damaging agents on the complete pool of ~4,700 barcoded homozygous deletion strains of Saccharomyces cerevisiae. In our protocol, deletion strains are pooled together and grown competitively in the presence of compound. Relative strain sensitivity is determined by hybridization of PCR-amplified barcodes to an oligonucleotide array carrying the barcode complements. These screens identified genes in well-characterized DNA-damage-response pathways as well as genes whose role in the DNA-damage response had not been previously established. High-throughput individual growth analysis was used to independently confirm microarray results. Each compound produced a unique genome-wide profile. Analysis of these data allowed us to determine the relative importance of DNA-repair modules for resistance to each of the 12 profiled compounds. Clustering the data for 12 distinct compounds uncovered both known and novel functional interactions that comprise the DNA-damage response and allowed us to define the genetic determinants required for repair of interstrand cross-links. Further genetic analysis allowed determination of epistasis for one of these functional groups

Iodinated Cyanine Dyes: A New Class of Sensitisers for use in NIR Activated Photodynamic Therapy (PDT)

Iodinated cyanine dye 6a has been developed for use as a NIR excited photosensitiser in photodynamic therapy.</p

Multi-component measurements of the Jefferson Lab energy recovery linac electron beam using optical transition and diffraction radiation

High brightness electron accelerators, such as energy recovery linacs (ERL), often have complex particle distributions that can create difficulties in beam transport as well as matching to devices such as wigglers used to generate radiation from the beam. Optical transition radiation (OTR), OTR interferometry (OTRI) and optical diffraction-transition radiation interferometry (ODTRI) have proven to be effective tools for diagnosing both the spatial and angular distributions of charged particle beams. OTRI and ODTRI have been used to measure rms divergences and optical transverse phase space mapping has been demonstrated using OTRI. In this work we present the results of diagnostic experiments using OTR and ODR conducted at the Jefferson Laboratory 115 MeV ERL which show the presence of two separate components within the spatial and angular distributions of the beam. By assuming a correlation between the spatial and angular features we estimate an rms emittance value for each of the two components.Comment: 25 pages, 10 figures; accepted for publication in PRSTAB; minor formatting errors correcte

The Earth Effect in the MSW Analysis of the Solar Neutrino Experiments

We consider the Earth effect in the MSW analysis of the Homestake, Kamiokande, GALLEX, and SAGE solar neutrino experiments. Using the time-averaged data and assuming two-flavor oscillations, the large-angle region of the combined fit extends to much smaller angles (to $\sin^22\theta \simeq 0.1$) than when the Earth effect is ignored. However, the additional constraint from the Kamiokande II day-night data excludes most of the parameter space sensitive to the Earth effect independent of astrophysical uncertainties, and leaves only a small large-angle region close to maximal mixing at 90\% C.L. The nonadiabatic solution remains unaffected by the Earth effect and is still preferred. Both theoretical and experimental uncertainties are included in the analysis.Comment: (11 pages, Revtex 3.0 (can be changed to Latex), 3 postscript figures included, UPR-0570T