A randomised controlled trial of a cognitive behavioural intervention for women who have menopausal symptoms following breast cancer treatment (MENOS 1): Trial protocol

<p>Abstract</p> <p>Background</p> <p>This trial aims to evaluate the effectiveness of a group cognitive behavioural intervention to alleviate menopausal symptoms (hot flushes and night sweats) in women who have had breast cancer treatment. Hot flushes and night sweats are highly prevalent but challenging to treat in this population. Cognitive behaviour therapy has been found to reduce these symptoms in well women and results of an exploratory trial suggest that it might be effective for breast cancer patients. Two hypotheses are tested:</p> <p>Compared to usual care, group cognitive behavioural therapy will:</p> <p>1. Significantly reduce the problem rating and frequency of hot flushes and nights sweats after six weeks of treatment and at six months post-randomisation.</p> <p>2. Improve mood and quality of life after six weeks of treatment and at six months post-randomisation.</p> <p>Methods/Design</p> <p>Ninety-six women who have completed their main treatment for breast cancer and who have been experiencing problematic hot flushes and night sweats for over two months are recruited into the trial from oncology and breast clinics in South East London. They are randomised to either six weekly group cognitive behavioural therapy (Group CBT) sessions or to usual care. Group CBT includes information and discussion about hot flushes and night sweats in the context of breast cancer, monitoring and modifying precipitants, relaxation and paced respiration, stress management, cognitive therapy for unhelpful thoughts and beliefs, managing sleep and night sweats and maintaining changes.</p> <p>Prior to randomisation women attend a clinical interview, undergo 24-hour sternal skin conductance monitoring, and complete questionnaire measures of hot flushes and night sweats, mood, quality of life, hot flush beliefs and behaviours, optimism and somatic amplification. Post-treatment measures (sternal skin conductance and questionnaires) are collected six to eight weeks later and follow-up measures (questionnaires and a use of medical services measure) at six months post-randomisation.</p> <p>Discussion</p> <p>MENOS 1 is the first randomised controlled trial of cognitive behavioural therapy for hot flushes and night sweats that measures both self-reported and physiologically indexed symptoms. The results will inform future clinical practice by developing an evidence-based, non-medical treatment, which can be delivered by trained health professionals.</p> <p>Trial Registration</p> <p>Current Controlled Trials <a href="http://www.controlled-trials.com/ISRCTN13771934">ISRCTN13771934</a></p

Large-scale structure of brown rat (Rattus norvegicus) populations in England: effects on rodenticide resistance

The brown rat (Rattus norvegicus) is a relatively recent (<300 years) addition to the British fauna, but by association with negative impacts on public health, animal health and agriculture, it is regarded as one of the most important vertebrate pest species. Anticoagulant rodenticides were introduced for brown rat control in the 1950s and are widely used for rat control in the UK, but long-standing resistance has been linked to control failures in some regions. One thus far ignored aspect of resistance biology is the population structure of the brown rat. This paper investigates the role population structure has on the development of anticoagulant resistance. Using mitochondrial and microsatellite DNA, we examined 186 individuals (from 15 counties in England and one location in Wales near the Wales–England border) to investigate the population structure of rural brown rat populations. We also examined individual rats for variations of the VKORC1 gene previously associated with resistance to anticoagulant rodenticides. We show that the populations were structured to some degree, but that this was only apparent in the microsatellite data and not the mtDNA data. We discuss various reasons why this is the case. We show that the population as a whole appears not to be at equilibrium. The relative lack of diversity in the mtDNA sequences examined can be explained by founder effects and a subsequent spatial expansion of a species introduced to the UK relatively recently. We found there was a geographical distribution of resistance mutations, and relatively low rate of gene flow between populations, which has implications for the development and management of anticoagulant resistance

What makes you not a Sikh? : a preliminary mapping of values

This study sets out to establish which Sikh values contrasted with or were shared by non-Sikh adolescents. A survey of attitude toward a variety of Sikh values was fielded in a sample of 364 non-Sikh schoolchildren aged between 13 and 15 in London. Values where attitudes were least positive concerned Sikh duties/code of conduct, festivals, rituals, prayer Gurdwara attendance, listening to scripture recitation, the amrit initiation. Sikh values empathized with by non-Sikhs concerned family pride, charity, easy access to ordination and Gurdwaras, maintaining the five Ks, seeing God in all things, abstaining from meat and alcohol and belief in the stories of Guru Nanak. Further significant differences of attitude toward Sikhism were found in comparisons by sex, age and religious affiliation. Findings are applied to teaching Sikhism to pupils of no faith adherence. The study recommends the extension of values mapping to specifically Sikh populations

Deterministic constant-depth preparation of the AKLT state on a quantum processor using fusion measurements

The ground state of the spin-1 Affleck, Kennedy, Lieb and Tasaki (AKLT) model is a paradigmatic example of both a matrix product state and a symmetry-protected topological phase, and additionally holds promise as a resource state for measurement-based quantum computation. Having a nonzero correlation length, the AKLT state cannot be exactly prepared by a constant-depth unitary circuit composed of local gates. In this work, we demonstrate that this no-go limit can be evaded by augmenting a constant-depth circuit with fusion measurements, such that the total preparation time is independent of system size and entirely deterministic. We elucidate our preparation scheme using the language of tensor networks, and furthermore show that the $\mathbb{Z}_2\times\mathbb{Z}_2$ symmetry of the AKLT state directly affords this speed-up over previously known preparation methods. To demonstrate the practical advantage of measurement-assisted preparation on noisy intermediate-scale quantum (NISQ) devices, we carry out our protocol on an IBM Quantum processor. We measure both the string order and entanglement spectrum of prepared AKLT chains and, employing these as metrics, find improved results over the known (purely unitary) sequential preparation approach. We conclude with a demonstration of quantum teleportation using the AKLT state prepared by our measurement-assisted scheme. This work thus serves to provide an efficient strategy to prepare a specific resource in the form of the AKLT state and, more broadly, experimentally demonstrates the possibility for realizable improvement in state preparation afforded by measurement-based circuit depth reduction strategies on NISQ-era devices.Comment: 17 pages, 8 figures. Supplemental Material: 13 pages, 11 figure

Memory-Guided Saccades in Psychosis: Effects of Medication and Stimulus Location.

The memory-guided saccade task requires the remembrance of a peripheral target location, whilst inhibiting the urge to make a saccade ahead of an auditory cue. The literature has explored the endophenotypic deficits associated with differences in target laterality, but less is known about target amplitude. The data presented came from Crawford et al. (1995), employing a memory-guided saccade task among neuroleptically medicated and non-medicated patients with schizophrenia (n = 31, n = 12), neuroleptically medicated and non-medicated bipolar affective disorder (n = 12, n = 17), and neurotypical controls (n = 30). The current analyses explore the relationships between memory-guided saccades toward targets with different eccentricities (7.5° and 15°), the discernible behaviour exhibited amongst diagnostic groups, and cohorts distinguished based on psychotic symptomatology. Saccade gain control and final eye position were reduced among medicated-schizophrenia patients. These metrics were reduced further among targets with greater amplitudes (15°), indicating greater deficit. The medicated cohort exhibited reduced gain control and final eye positions in both amplitudes compared to the non-medicated cohort, with deficits markedly observed for the furthest targets. No group differences in symptomatology (positive and negative) were reported, however, a greater deficit was observed toward the larger amplitude. This suggests that within the memory-guided saccade paradigm, diagnostic classification is more prominent in characterising disparities in saccade performance than symptomatology

Marital interaction theory: some implications for research

This project examines specific basic areas of marital interaction theory. Individual chapters are developed around the following themes: historical development of the theory of interaction; a theoretical discussion of selected concepts; personality as a determinant of interaction; communication in marriage; marital interaction patterns; methodology pertaining to research findings; and finally some implications for research which became apparent as this project developed. The project lays the conceptual groundwork for a series of empirical studies that will use the interactional approach as a theoretical base. The immediate purpose of this project therefore is to describe the important dimensions of the interactional approach as these pertain to marital interaction. Interaction is defined as a reciprocal relationship in which each person may produce effects upon the other. Here the essence of marriage is interaction; thus marital interaction is critical in its effect on the spouses and the continuity of the marriage. Some of the basic concepts of George Mead are described and it is suggested that they are essential elements of the interactional approach. The major assumptions of this approach are that a) human behavior cannot be derived or inferred from nonhuman forms, b) the social act is the primary analytic unit for an understanding of society and the personality, c) the human infant is potentially social, and d) the human being is actor as well as reactor. Personality is discussed as a determinant of the quality and quantity of marital interaction. The issue of personal competence is explored, particularly in respect to verbal ability. Communication, the process of influence, is defined for marital interaction and the consequent formation of patterns. Identification and classification of marital interaction patterns are limited to a description of selected examples from family research and the observations of clinicians. Patterns tend to be defined in psychological terms although communicative behavior is stressed. The absence of common criteria and terminology is noted. Description of dysfunctional patterns predominates. Two methods frequently used in recent studies of marital interaction are direct observation and analysis of reports from marital partners. It is suggested that a combination of these techniques could increase the quantity of information about marital interaction. Research questions focus on the problem of adult socialization, its implications for the establishment of marital interaction patterns, and the need to determine the relation between the interaction process and the functional or dysfunctional quality of the resultant pattern. An inseparable part of the aforementioned research areas is the function of communication. It is suggested that investigation of verbal communication might yield significant data for the understanding of the interaction process as it affects the personalities of the spouses and the formation of patterns

White Matter Hyperintensity Associations with Cerebral Blood Flow in Elderly Subjects Stratified by Cerebrovascular Risk

Objective: This study aims to add clarity to the relationship between deep and periventricular brain white matter hyperintensities (WMHs), cerebral blood flow (CBF), and cerebrovascular risk in older persons. Methods: Deep white matter hyperintensity (dWMH) and periventricular white matter hyperintensity (pWMH) and regional gray matter (GM) and white matter (WM) blood flow from arterial spin labeling were quantified from magnetic resonance imaging scans of 26 cognitively normal elderly subjects stratified by cerebrovascular disease (CVD) risk. Fluidattenuated inversion recovery images were acquired using a high-resolution 3-dimensional (3-D) sequence that reduced partial volume effects seen with slicebased techniques. Results: dWMHs but not pWMHs were increased in patients at high risk of CVD; pWMHs but not dWMHs were associated with decreased regional cortical (GM) blood flow. We also found that blood flow in WM is decreased in regions of both pWMH and dWMH, with a greater degree of decrease in pWMH areas. Conclusions: WMHs are usefully divided into dWMH and pWMH regions because they demonstrate differential effects. 3-D regional WMH volume is a potentially valuable marker for CVD based on associations with cortical CBF and WM CBF