916 research outputs found

    Guided self-help interventions for mental health disorders in children with neurological conditions: study protocol for a pilot randomised controlled

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    Background: Rates of mental health disorders are significantly greater in children with physical illnesses than in physically well children. Children with neurological conditions, such as epilepsy, are known to have particularly high rates of mental health disorders. Despite this, mental health problems in children with neurological conditions have remained under-recognised and under-treated in clinical settings. Evidence-based guided self-help interventions are efficacious in reducing symptoms of mental health disorders in children, but their efficacy in reducing symptoms of common mental health disorders in children with neurological conditions has not been investigated. We aim to pilot a guided self-help intervention for the treatment of mental health disorders in children with neurological conditions. Methods/design: A pilot randomised controlled trial with 18 patients with neurological conditions and mental health disorders will be conducted. Participants attending specialist neurology clinics at a National UK Children’s Hospital will be randomised to receive guided self-help for common mental health disorders or to a 12-week waiting list control. Participants in the treatment group will receive 10 sessions of guided self-help delivered over the telephone. The waiting list control group will receive the intervention after a waiting period of 12 weeks. The primary outcome measure is reduction in symptoms of mental health disorders. Exclusion criteria are limited to those at significant risk of harm to self or others, the presence of primary mental health disorder other than anxiety, depression or disruptive behaviour (e.g. psychosis, eating disorder, obsessive-compulsive disorder) or intellectual disability at a level meaning potential participants would be unable to access the intervention. The study has ethical approval from the Camden and Islington NHS Research Ethics Committee, registration number 14.LO.1353. Results will be disseminated to patients, the wider public, clinicians and researchers through publication in journals and presentation at conferences. Discussion: This is the first study to investigate guided self-help interventions for mental health problems in children with neurological conditions, a group which is currently under-represented in mental health research. The intervention is modular and adapted from an empirically supported cognitive behavioural treatment. The generalisability and broad inclusion criteria are strengths but may also lead to some weaknesses

    An exploratory cluster randomised trial of a university halls of residence based social norms marketing campaign to reduce alcohol consumption among 1st year students

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    <p>Aims: This exploratory trial examines the feasibility of implementing a social norms marketing campaign to reduce student drinking in universities in Wales, and evaluating it using cluster randomised trial methodology.</p> <p>Methods: Fifty residence halls in 4 universities in Wales were randomly assigned to intervention or control arms. Web and paper surveys were distributed to students within these halls (n = 3800), assessing exposure/contamination, recall of and evaluative responses to intervention messages, perceived drinking norms and personal drinking behaviour. Measures included the Drinking Norms Rating Form, the Daily Drinking Questionnaire and AUDIT-C.</p> <p>Results: A response rate of 15% (n = 554) was achieved, varying substantially between sites. Intervention posters were seen by 80% and 43% of students in intervention and control halls respectively, with most remaining materials seen by a minority in both groups. Intervention messages were rated as credible and relevant by little more than half of students, though fewer felt they would influence their behaviour, with lighter drinkers more likely to perceive messages as credible. No differences in perceived norms were observed between intervention and control groups. Students reporting having seen intervention materials reported lower descriptive and injunctive norms than those who did not.</p> <p>Conclusions: Attention is needed to enhancing exposure, credibility and perceived relevance of intervention messages, particularly among heavier drinkers, before definitive evaluation can be recommended. A definitive evaluation would need to consider how it would achieve sufficient response rates, whilst hall-level cluster randomisation appears subject to a significant degree of contamination.</p&gt

    Is automatic imitation a specialized form of stimulus–response compatibility? Dissociating imitative and spatial compatibilities

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    In recent years research on automatic imitation has received considerable attention because it represents an experimental platform for investigating a number of inter-related theories suggesting that the perception of action automatically activates corresponding motor programs. A key debate within this research centers on whether automatic imitation is any different than other long-term S-R associations, such as spatial stimulus-response compatibility. One approach to resolving this issue is to examine whether automatic imitation shows similar response characteristics as other classes of stimulus-response compatibility. This hypothesis was tested by comparing imitative and spatial compatibility effects with a two alternative forced-choice stimulus-response compatibility paradigm and two tasks: one that involved selecting a response to the stimulus (S-R) and one that involved selecting a response to the opposite stimulus (OS-R), i.e., the one not presented. The stimulus for both tasks was a left or right hand with either the index or middle finger tapping down. Speeded responses were performed with the index or middle finger of the right hand in response to the finger identity or the left-right spatial position of the fingers. Based on previous research and a connectionist model, we predicted standard compatibility effects for both spatial and imitative compatibility in the S-R task, and a reverse compatibility effect for spatial compatibility but not for imitative compatibility in the OS-R task. The results from the mean response times, mean percentage of errors, and response time distributions all converged to support these predictions. A second noteworthy result was that the recoding of the finger identity in the OS-R task required significantly more time than the recoding of the left-right spatial position, but the encoding time for the two stimuli in the S-R task was equivalent. In sum, this evidence suggests that the processing of spatial and imitative compatibility is dissociable with regard to two different processes in dual processing models of stimulus-response compatibility

    Participation and satisfaction after spinal cord injury: results of a vocational and leisure outcome study

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    Study design: Survey. Objectives: Insight in (1) the changes in participation in vocational and leisure activities and (2) satisfaction with the current participation level of people with spinal cord injuries (SCIs) after reintegration in society. Design: Descriptive analysis of data from a questionnaire. Setting: Rehabilitation centre with special department for patients with SCIs, Groningen, The Netherlands. Subjects: A total of 57 patients with traumatic SCI living in the community, who were admitted to the rehabilitation centre two to 12 years before the current assessment. Main outcome measures: Changes in participation in activities; current life satisfaction; support and unmet needs. Results: Participation expressed in terms of hours spent on vocational and leisure activities changed to a great extent after the SCI. This was mainly determined by a large reduction of hours spent on paid work. While 60% of the respondents successfully reintegrated in work, many changes took place in the type and extent of the job. Loss of work was partially compensated with domestic and leisure activities. Sports activities were reduced substantially. The change in participation level and compensation for the lost working hours was not significantly associated with the level of SCI-specific health problems and disabilities. As was found in other studies, most respondents were satisfied with their lives. Determinants of a negative life satisfaction several years following SCI were not easily indicated. Reduced quality of life was particularly related to an unsatisfactory work and leisure situation. Conclusions: Most people with SCI in this study group were able to resume work and were satisfied with their work and leisure situation

    Yield in almond is related more to the abundance of flowers than the relative number of flowers that set fruit

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    Almond tree yield is a function of the number of flowers on a tree and the percentage of flowers that set fruit. Almonds are borne on spurs (short proleptic shoots that can have both leaves and flowers). Almond tree spur dynamics research has documented that previous year spur leaf area is a predictive parameter for year-to-year spur survival, spur flowering and to a lesser extent spur fruiting, while previous year fruit bearing has a negative impact on subsequent year flowering. However, a question remained about whether yields are more dependent on flower numbers or relative fruit set of the flowers that are present. The aim of the present work was to compare the importance of flower abundance with that of relative fruit set in determining the productivity of a population of tagged spurs in almond trees over a 6-year period. Overall tree yield among years was more sensitive to total number of flowers on a tree rather than relative fruit set. These results emphasize the importance of maintaining large populations of healthy flowering spurs for sustained high production in almond orchards

    Seismic Testing of Adjacent Interacting Masonry Structures

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    In many historical centres in Europe, stone masonry buildings are part of building aggregates, which developed when the layout of the city or village was densified. In these aggregates, adjacent buildings share structural walls to support floors and roofs. Meanwhile, the masonry walls of the façades of adjacent buildings are often connected by dry joints since adjacent buildings were constructed at different times. Observations after for example the recent Central Italy earthquakes showed that the dry joints between the building units were often the first elements to be damaged. As a result, the joints opened up leading to pounding between the building units and a complicated interaction at floor and roof beam supports. The analysis of such building aggregates is very challenging and modelling guidelines do not exist. Advances in the development of analysis methods have been impeded by the lack of experimental data on the seismic response of such aggregates. The objective of the project AIMS (Seismic Testing of Adjacent Interacting Masonry Structures), included in the H2020 project SERA, is to provide such experimental data by testing an aggregate of two buildings under two horizontal components of dynamic excitation. The test unit is built at half-scale, with a two-storey building and a one-storey building. The buildings share one common wall while the façade walls are connected by dry joints. The floors are at different heights leading to a complex dynamic response of this smallest possible building aggregate. The shake table test is conducted at the LNEC seismic testing facility. The testing sequence comprises four levels of shaking: 25%, 50%, 75% and 100% of nominal shaking table capacity. Extensive instrumentation, including accelerometers, displacement transducers and optical measurement systems, provides detailed information on the building aggregate response. Special attention is paid to the interface opening, the global behaviour in relation to the interface separation, interstorey drifts and out-of-plane displacements

    Organism-sediment interactions govern post-hypoxia recovery of ecosystem functioning

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    Hypoxia represents one of the major causes of biodiversity and ecosystem functioning loss for coastal waters. Since eutrophication-induced hypoxic events are becoming increasingly frequent and intense, understanding the response of ecosystems to hypoxia is of primary importance to understand and predict the stability of ecosystem functioning. Such ecological stability may greatly depend on the recovery patterns of communities and the return time of the system properties associated to these patterns. Here, we have examined how the reassembly of a benthic community contributed to the recovery of ecosystem functioning following experimentally-induced hypoxia in a tidal flat. We demonstrate that organism-sediment interactions that depend on organism size and relate to mobility traits and sediment reworking capacities are generally more important than recovering species richness to set the return time of the measured sediment processes and properties. Specifically, increasing macrofauna bioturbation potential during community reassembly significantly contributed to the recovery of sediment processes and properties such as denitrification, bedload sediment transport, primary production and deep pore water ammonium concentration. Such bioturbation potential was due to the replacement of the small-sized organisms that recolonised at early stages by large-sized bioturbating organisms, which had a disproportionately stronger influence on sediment. This study suggests that the complete recovery of organism-sediment interactions is a necessary condition for ecosystem functioning recovery, and that such process requires long periods after disturbance due to the slow growth of juveniles into adult stages involved in these interactions. Consequently, repeated episodes of disturbance at intervals smaller than the time needed for the system to fully recover organism-sediment interactions may greatly impair the resilience of ecosystem functioning.

    Caregiver stress in traumatic brain injury

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    Aims Many patients experience physical, behavioural, cognitive and emotional problems following traumatic brain injury (TBI). They may require continuing care for many years, most of which is provided by informal caregivers, such as spouses, parents, or other family members. The caregiving role is associated with a range of adverse effects including anxiety, depression, poor physical health and lowered quality of life. This article explores issues around caregiver stress; highlighting interventions for this group and areas for further research. Methods Literature exploring the impact of caregiving, its influencing and alleviating factors and interventions for caregivers of people with TBI is discussed, with brief critical analysis of key studies. Findings Research suggests that caregiver characteristics, coping strategies, their appraisal of the situation and social networks may be associated with the amount of distress experienced. Many caregivers have unmet needs such as respite care and information provision on TBI. Providing information may help to alleviate strain. Community-based family therapies providing education, support and counselling can help to decrease distress and improve aspects of family functioning, although evidence for these is lacking. Conclusions There is a need for more well-designed, controlled studies evaluating the impact of interventions to alleviate caregiver strain
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