Euphoria in multiple sclerosis: an investigation of constructs and symptons

Includes bibliographical references.In multiple sclerosis (MS), some patients are said to present with unawareness of deficit, and positive mood and optimism that is out of place or incongruous given the patient's circumstances. The history of these symptoms, collectively known as euphoria, however, is characterised by marked inconsistencies regarding a number of aspects of these symptoms. This research attempted to investigate both the constructs, and the symptoms themselves, with the aim of better defining and broadening our understanding of euphoria. Results revealed that a change in the definition of euphoria appears to have occurred since the concept was introduced by Cottrell and Wilson. Different operational definitions appear to be partly responsible for the very different incidence rates reported throughout the literature. Instead of the classical three types of euphoria identified by the classical authors, or the single type utilised in the contemporary literature, the current research revealed two types of euphoria in MS (viz. positivity and unawareness). Positivity appears to be a subjective mood/outlook experienced by the patient and not an outward façade projected by the euphoric individual, and was defined in fairly subtle terms. Unawareness appears to relate to a number of domains (including physical, cognitive and mood or behavioural deficits), and was measured via participant/informant discrepancies on self-report questionnaires. Both positivity and unawareness were represented on a continuum and appeared to have different demographic, disease and cognitive correlates. Positivity was significantly predicted by a medical history of conditions that can affect neuropsychological functioning. Unawareness of physical deficits was associated with a female gender, a younger age, a lower income, relapsing-remitting course, a current disease state of relapse or exacerbation, a shorter disease duration, but a greater disease severity in terms of physical disability. Severity of the disease and the cognitive composite representing cognitive functions sub-served by the orbitobasal frontal cortex were also significant individual predictors of unawareness of physical deficits. Visuospatial ability significantly predicted unawareness of cognitive deficits. No demographic, disease or cognitive correlates of unawareness of mood or behavioural deficits were identified. Finally, no indisputable single cause underlying the two types of euphoria in MS identified by this research was isolated by the exploratory investigations undertaken; however interesting preliminary findings that may tentatively implicate executive dysfunction as well as, possibly, immunological disease processes in the etiology of euphoria in MS were revealed. These results have broadened our understanding of euphoria in MS and may shape both the research and clinical work with euphoric patients going forward

Nutritional and Phytochemical Content of High-Protein Crops

The authors acknowledge support from the Scottish Government’s Rural and Environment Science and Analytical Services Division (RESAS) via their strategic research and partnership programs.Peer reviewedPostprin

Treatment burden in survivors of prostate and colorectal cancer: : a qualitative interview study.

Peer reviewedPostprin

Simulating the coronal evolution of bipolar active regions to investigate the formation of flux ropes

Funding: S.L.Y. would like to acknowledge STFC for support via the Consolidated Grant SMC1/YST025. D.H.M. would like to thank STFC, the Leverhulme Trust and the ERC under the Synergy Grant: The Whole Sun, grant agreement no. 810218 for financial support. L.M.G. is thankful to the Royal Society for a University Research Fellowship and the Leverhulme Trust.The coronal magnetic field evolution of 20 bipolar active regions (ARs) is simulated from their emergence to decay using the time-dependent nonlinear force-free field method of Mackay, Green, and van Ballegooijen (Astrophys. J. 729, 97, 2011). A time sequence of cleaned photospheric line-of-sight magnetograms, which covers the entire evolution of each AR, is used to drive the simulation. A comparison of the simulated coronal magnetic field with the 171 and 193 Å observations obtained by the Solar Dynamics Observatory (SDO)/Atmospheric Imaging Assembly (AIA), is made for each AR by manual inspection. The results show that it is possible to reproduce the evolution of the main coronal features such as small- and large-scale coronal loops, filaments and sheared structures for 80% of the ARs. Varying the boundary and initial conditions, along with the addition of physical effects such as Ohmic diffusion, hyperdiffusion and a horizontal magnetic field injection at the photosphere, improves the match between the observations and simulated coronal evolution by 20%. The simulations were able to reproduce the build-up to eruption for 50% of the observed eruptions associated with the ARs. The mean unsigned time difference between the eruptions occurring in the observations compared to the time of eruption onset in the simulations was found to be ≈5 hrs. The simulations were particularly successful in capturing the build-up to eruption for all four eruptions that originated from the internal polarity inversion line of the ARs. The technique was less successful in reproducing the onset of eruptions that originated from the periphery of ARs and large-scale coronal structures. For these cases global, rather than local, nonlinear force-free field models must be used. While the technique has shown some success, eruptions that occur in quick succession are difficult to reproduce by this method and future iterations of the model need to address this.Publisher PDFPeer reviewe

An investigation into the impact childhood abuse may have in the presentation of negative symptoms in patients with first-episode psychosis

This thesis covers key issues within clinical and health psychology over three chapters. Chapter 1 examines coeliac disease and its impact in older people to help provide much needed insight into the problems encountered. Coeliac disease in older age has often been ignored within the literature and thus, little is known of its impact. This literature review provides a clearer understanding of what is already known as well as highlighting areas which need further exploration. Chapter 2 centers on the recruitment process of a larger study which examined the neurological and psychological overlap between autism and psychosis. This detailed the importance of building a good rapport between researchers and external services to gather participants, as well as the obstacles which may present when working with this particular clinical group. Chapter 3 looks more specifically at the impact childhood abuse can have on experiencing psychosis, particularly in how it may affect symptomatology. Positive symptoms, such as hallucinations, have been heavily studied with findings indicating a strong link with childhood abuse. However, the presence of negative symptoms has received little attention. Thus, this chapter seeks to address this problem

Vertical Woman: a Collection of Poems

There are a number of people who, without their heip and their interest in my work, this collection could not be possible. First and foremost, I am greatly indebted to my teacher and friend, Dr. Terry Htnnmer, who taught me that writing poetry is no easy task. He has been solely responsible for shaping my belief that what I am doing is somehow significant and noble.Englis

Black women's experiences of pregnancy and birth

This thesis was completed as part of the Clinical Psychology Doctorate programme and includes three chapters. Chapter one is a meta-analysis examining the current literature on the prevalence rates for perinatal post-traumatic stress disorder following childbirth. Chapter two is an empirical paper exploring Black women’s experiences of pregnancy and birth from a qualitative stance. Chapter three comprises of a press release for both papers, conveying findings in an accessible manner

Hardware accelerated image processing to enable real-time adaptive radiotherapy

The accuracy of radiotherapy is constrained by organ motion and deformation occurring between the acquisition of CT and MR images used to plan the treatment and the time at which the treatment is delivered. Adaptive radiotherapy uses image data acquired at the time of treatment to adapt the original treatment plan to match the current patient anatomy. Currently, the image processing and dose calculation algorithms required to perform this plan adaptation cannot be executed in a clinically acceptable timeframe. Hardware acceleration has the potential to speedup these algorithms, making real-time adaptive radiotherapy a clinical possibility[1]. Hardware acceleration is a technique where an algorithm is implemented using hardware that is better suited to the specific algorithm than more general purpose processors in order to reduce the execution time of the algorithm. This can be achieved using field programmable gate arrays (FPGA), which are devices consisting of reconfigurable hardware, allowing their function to be customised for a specific application. These devices have been shown to be able to accelerate image processing algorithms pertinent to adaptive radiotherapy[2]. In this study a global thresholding algorithm based on Otsu’s method combined with a three dimensional mean filter was used to segment a series of CT images of a Modus QUASAR respiratory motion phantom into three unique classes. A Xilinx Zynq Z-7020 device consisting of a dual-core ARM Cortex-A9 central processing unit (CPU) coupled to an 85 000 logic cell FPGA was used to accelerate the algorithm by implementing sections of it in the reconfigurable hardware. The execution time of this implementation was compared to an implementation running on an ARM CPU and Intel Core-i5 CPU. The execution times of the implementations are shown in table 1. The hardware accelerated implementation was found to execute nearly sixty times as fast as the un-accelerated algorithm. The hardware accelerated implementation was also found to run around 14% faster than on the more powerful Intel Core-i5 CPU. Figure 1 shows an example of the segmentation results where the blue contour represents the boundary between two of the classes. In the algorithms presented here the overhead of transferring data to the hardware represents a significant proportion of the algorithm execution time. It is anticipated that greater acceleration will be possible for algorithms with greater computational complexity because the data transfer overhead will represent a smaller proportion of the overall execution time. The requirement for fast processing in radiotherapy is likely to increase as the amount of data available to more accurately guide treatment increases through the use of techniques such as 4D CT and image-guided radiotherapy. FPGA have been shown to be effective at accelerating certain algorithms required for real-time adaptive radiotherapy, however, more research is required to establish which will execute faster on other types of hardware, such as CPU and graphical processing units (GPU). It is likely that heterogeneous computing platforms, composed of a mixture of hardware architectures, will be used in the future implementation of real-time adaptive radiotherapy. References: 1.K. Østergaard Noe, B.D. De Senneville, U.V. Elstrøm, K. Tanderup, T.S. Sørensen, “Acceleration and validation of optical flow based deformable registration for image-guided radiotherapy,” Acta Oncologica, vol. 47, no. 7, pp.1286-1293, 2008 2.O. Dandekar, R. Shekhar, “FPGA-Accelerated Deformable Image Registration for Improved Target-Delineation During CT-Guided Interventions,” IEEE Trans. Biomed. Circuits Syst., vol. 1, no. 2, pp.116-127, 200