Personality disorder in primary care : factors associated with therapy process and outcome.

Assessment and treatment of personality disorder (PD) is a key issue in UK mental health service provision (NIMH report, 2003), but there is limited information on individuals with personality disorder presenting to primary care mental health services. This study investigates the characteristics of PD in individuals receiving cognitive behaviour therapy (CBT) following GP referral and its relationship with therapist ratings of treatment process and outcome. One hundred and forty-eight participants completed the Millon Multiaxial Clinical Inventory (MCMI-III: Millon, Davis and Millon, 1997). Therapists completed a measure of therapy process and outcome (TPOQ) on 100 participants. Key therapy and process questions were answered for 60 participants who attended a minimum of five therapy sessions. MCMI-III indicated a rate of PD of 56.4%. Factor analysis of PD scales identified two factors: inward looking/emotionally distanced, and aggressive/acting out. For clinical syndromes (CLS), the factors were general psychopathology and substance abuse. TPOQ had two factors: therapeutic alliance and complexity in therapy. Regression analyses indicated that only those PDs contributing to the inward looking/emotionally distanced scale score were associated with therapeutic alliance problems. Conversely, complexity in therapy was only predicted by general psychopathology and not by personality disorder. This study identified high rates of personality disorder in primary care referrals to a clinical psychology service. It also indicated that relationships between the presence of personality disorder and therapist ratings of treatment difficulties were only associated with certain types of personality disorder. These findings are discussed in relation to service and therapy planning in mental health

The shelf life of wine

The aim of this project was to investigate and develop models for the shelf life of bottled wine and, in particular, the effects of elevated temperatures to the ageing process. The problem was divided into three sub-problems. First, calculations were made to describe the temperature of wine in a single bottle when subjected to an elevated external temperature, and then this was extended to pallets of cartons of wine. Second, equations were derived for the gas flow through the cork when a wine bottle is subject to oscillatory external temperatures, as is common in a domestic storage situation. Third, the temperature dependent reaction rates of the wine ageing process were considered and calculations performed on how elevated decrease shelf life. Suggestions were made as to relatively simple experiments that can be performed to test the models presented here

Interlacing - extremal graphs

A graph G is singular if the zero-one adjacency matrix has the eigenvalue zero. The multiplicity of the eigenvalue zero is called the nullity of G. For two vertices y and z of G, we call (G, y, z) a device with respect to y and z. The nullities of G, G − y,  G − z and G − y − z classify devices into different kinds. We identify two particular classes of graphs that correspond to distinct kinds. In the first, the devices have the minimum allowed value for the nullity of G − y − z relative to that of G for all pairs of distinct vertices y and z of G. In the second, the nullity of G − y reaches the maximum possible for all vertices y in a graph G. We focus on the non–singular devices of the second kind.peer-reviewe

Watchful Waiting vs. Immediate Transurethral Prostatectomy for Symptomatic Prostatism

The rate of resection for benign prostatic hypertrophy shows considerable variability among small geographic areas. To help inform the decision to recommend prostatectomy to men with prostatism without signs of chronic retention, we performed a decision analysis to compare the expected outcomes with immediate transurethral resection and watchful waiting. Data used in the model originated from the medical literature, Medicare claims data, and patient interview studies. In our base-case for 70-year-old men, immediate surgery resulted in the loss of 1.01 months of life expectancy, but when adjustments were made for quality of life, immediate surgery was favored with a net utility benefit of 2.94 quality-adjusted life-months. However, the analysis was particularly sensitive to the degree of disutility attributed to the index symptoms of prostatism. We conclude that patient preferences should be the dominant factor in the decision whether to recommend prostatectomy

Two Test Level 4 Bridge Railing and Transition Systems for Transverse Timber Deck Bridges

The Midwest Roadside Safety Facility, in cooperation with the Forest Products Laboratory, which is part of the U.S. Department of Agriculture’s Forest Service, and FHWA, designed two bridge railing and approach guardrail transition systems for use on bridges with transverse glue-laminated timber decks. The bridge raging and transition systems were developed and crash tested for use on higher-service-level roadways and evaluated according to the Test Level 4 safety performance criteria presented in NCHRP Report 350: Recommended Procedures for the Safety Performance Evaluation of Highway Features. The first railing system was constructed with glulam timber components, whereas the second railing system was configured with steel hardware. Eight full-scale crash tests were performed, and the bridge railing and transition systems were acceptable according to current safety standards

An intrauterine device with potential to control fertility in feral equids

Fertility control of feral equids is difficult. A 4-month pilot study was conducted with a hormone free intrauterine device (iUPOD). There was evaluation of i) device retention; ii) contraceptive efficacy; iii) fertility following device removal; iv) effects of device on estrous cycle periodicity and; v) abundance of biofilm on devices after removal from the uterus. The iUPODs were inserted trans-cervically in eight mares at random stages of the estrous cycle. Mares were confined in a paddock with a stallion the following day and remained with the stallion for 120 days. Transabdominal detection of the iUPOD, using a non-invasive handheld magnetic detector wand, was performed weekly. Mares were examined using transrectal ultrasonography on days 0 (Time at insertion = day 0), 14, and 30, and subsequently every third week to assess number and size of follicles, corpora lutea, and whether there was intrauterine fluid (IUF) present. The mares and stallion were observed daily for mating behavior. Weekly samples were assayed for progesterone (P4) at day 0 and until 3 weeks subsequent to stallion removal. None of the mares became pregnant while fitted with the iUPOD. Two of four mares conceived within 30 days subsequent to iUPOD removal. Three of eight mares fitted with the device had periods greater than 14 days with P4 concentrations 1 ng/mL. There was a marked abundance of biofilm on devices of two mares at the time of device removal

Two Test Level 4 Bridge Railing and Transition Systems for Transverse Timber Deck Bridges

The Midwest Roadside Safety Facility, in cooperation with the Forest Products Laboratory, which is part of the U.S. Department of Agriculture’s Forest Service, and FHWA, designed two bridge railing and approach guardrail transition systems for use on bridges with transverse glue-laminated timber decks. The bridge raging and transition systems were developed and crash tested for use on higher-service-level roadways and evaluated according to the Test Level 4 safety performance criteria presented in NCHRP Report 350: Recommended Procedures for the Safety Performance Evaluation of Highway Features. The first railing system was constructed with glulam timber components, whereas the second railing system was configured with steel hardware. Eight full-scale crash tests were performed, and the bridge railing and transition systems were acceptable according to current safety standards

Scope and Predictive Genetic/Phenotypic Signatures of Bicarbonate (NaHCO3) Responsiveness and β-Lactam Sensitization in Methicillin-Resistant Staphylococcus aureus.

Addition of sodium bicarbonate (NaHCO3) to standard antimicrobial susceptibility testing medium reveals certain methicillin-resistant Staphylococcus aureus (MRSA) strains to be highly susceptible to β-lactams. We investigated the prevalence of this phenotype (NaHCO3 responsiveness) to two β-lactams among 58 clinical MRSA bloodstream isolates. Of note, ∼75% and ∼36% of isolates displayed the NaHCO3 responsiveness phenotype to cefazolin (CFZ) and oxacillin (OXA), respectively. Neither intrinsic β-lactam MICs in standard Mueller-Hinton broth (MHB) nor population analysis profiles were predictive of this phenotype. Several genotypic markers (clonal complex 8 [CC8]; agr I and spa t008) were associated with NaHCO3 responsiveness for OXA