The clinical and cost-effectiveness of a Victim Improvement Package (VIP) for the reduction of chronic symptoms of depression or anxiety in older victims of common crime (the VIP trial): study protocol for a randomised controlled trial.

BACKGROUND: Older people are vulnerable to sustained high levels of psychosocial distress following a crime. A cognitive behavioural therapy (CBT)-informed psychological therapy, the Victim Improvement Package (VIP) may aid recovery. The VIP trial aims to test the clinical and cost-effectiveness of the VIP for alleviating depressive and anxiety symptoms in older victims of crime. METHODS/DESIGN: People aged 65 years or more who report being a victim of crime will be screened by Metropolitan Police Service Safer Neighbourhood Teams within a month of the crime for distress using the Patient Health Questionnaire-2 and the Generalised Anxiety Disorder-2. Those who screen positive will be signposted to their GP for assistance, and re-screened at 3 months. Participants who screen positive for depression and/or anxiety at re-screening are randomised to a CBT informed VIP added to treatment as usual (TAU) compared to TAU alone. The intervention consists of 10 individual 1-h sessions, delivered weekly by therapists from the mental health charity Mind. The primary outcome measure is the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI), used as a composite measure, assessed at 6 months after the crime (post therapy) with a 9-month post-crime follow-up. Secondary outcome measures include the EQ-5D, and a modified Client Service Receipt Inventory. A total of 226 participants will be randomised VIP:TAU with a ratio 1:1, in order to detect a standardised difference of at least 0.5 between groups, using a mixed-effects linear-regression model with 90% power and a 5% significance level (adjusting for therapist clustering and potential drop-out). A cost-effectiveness analysis will incorporate intervention costs to compare overall health care costs and quality of life years between treatment arms. An embedded study will examine the impact of past trauma and engagement in safety behaviours and distress on the main outcomes. DISCUSSION: This trial should provide data on the clinical and cost-effectiveness of a CBT-informed psychological therapy for older victims of crime with anxiety and/or depressive symptoms and should demonstrate a model of integrated cross-agency working. Our findings should provide evidence for policy-makers, commissioners and clinicians responding to the needs of older victims of crime. TRIAL REGISTRATION: International Standard Randomised Controlled Trials Number, ID: ISRCTN16929670. Registered on 3 August 2016

Attention and automation: New perspectives on mental underload and performance

There is considerable evidence in the ergonomics literature that automation can significantly reduce operator mental workload. Furthermore, reducing mental workload is not necessarily a good thing, particularly in cases where the level is already manageable. This raises the issue of mental underload, which can be at least as detrimental to performance as overload. However, although it is widely recognized that mental underload is detrimental to performance, there are very few attempts to explain why this may be the case. It is argued in this paper that, until the need for a human operator is completely eliminated, automation has psychological implications relevant in both theoretical and applied domains. The present paper reviews theories of attention, as well as the literature on mental workload and automation, to synthesize a new explanation for the effects of mental underload on performance. Malleable attentional resources theory proposes that attentional capacity shrinks to accommodate reductions in mental workload, and that this shrinkage is responsible for the underload effect. The theory is discussed with respect to the applied implications for ergonomics research

Generation Of High Non-inductive Plasma Current Fraction H-mode Discharges By High-harmonic Last Wave Heating In The National Spherical Torus Experiment

1.4 MW of 30 MHz high-harmonic fast wave (HHFW) heating, with current drive antenna phasing, has generated a Ip = 300kA, BT (0) = 0.55T deuterium H-mode plasma in the National Spherical Torus Experiment that has a non-inductive plasma current fraction, fNI = 0.7-1. Seventy-five percent of the non-inductive current was generated inside an internal transport barrier that formed at a normalized minor radius, r/a {approx} 0.4 . Three quarters of the non-inductive current was bootstrap current and the remaining non-inductive current was generated directly by HHFW power inside r/a {approx} 0.2

Low Velocity Ionized Winds from Regions Around Young O Stars

We have observed seven ultracompact HII regions in hydrogen recombination lines in the millimeter band. Toward four of these regions, there is a high velocity (full width to half maximum 60-80 km/s) component in the line profiles. The high velocity gas accounts for 35-70% of the emission measure within the beam. We compare these objects to an additional seven similar sources we have found in the literature. The broad recombination line objects (BRLOs) make up about 30% of all sources in complexes containing ultracompact HII regions. Comparison of spectral line and continuum data implies that the BRLOs coincide with sources with rising spectral indices, >=0.4 up to 100 GHz. Both the number of BRLOs and their frequency of occurrence within HII region complexes, when coupled with their small size and large internal motions, mean that the apparent contradiction between the dynamical and population lifetimes for BRLOs is even more severe than for ultracompact HII regions. We evaluate a number of models for the origin of the broad recombination line emission. The lifetime, morphology, and rising spectral index of the sources argue for photo- evaporated disks as the cause for BRLOs. Existing models for such regions, however, do not account for the large amounts of gas observed at supersonic velocities.Comment: 36 pages, 8 figure

The RMS Survey: Mid-Infrared Observations of Candidate Massive YSOs in the Southern Hemisphere

Abridged abstract: The Red MSX Source (RMS) survey is an ongoing effort to return a large, well-selected sample of massive young stellar objects (MYSOs) within our Galaxy. A series of ground-based follow-up observations are being undertaken in order to remove contaminant objects from our list of 2000 candidates, and to begin characterising these MYSOs. As a part of these follow-up observations, high resolution (~1") mid-IR imaging aids the identification of contaminant objects which are resolved (UCHII regions, PN) as opposed to those which are unresolved (YSOs, evolved stars) as well as identifying YSOs near UCHII regions and other multiple sources. We present 10.4 micron imaging observations for 346 candidate MYSOs in the RMS survey in the Southern Hemisphere, primarily outside the region covered by the GLIMPSE Spitzer Legacy Survey. These were obtained using TIMMI2 on the ESO 3.6m telescope in La Silla, Chile. Our photometric accuracy is of order 0.05Jy, and our astrometric accuracy is 0.8", which is an improvement over the nominal 2" accuracy of the MSX PSC.Comment: 9 page paper accepted to A&A. Online data for table 2 and figure 1 will be available in the published online version of this paper via A&A. The paper contains 7 figures and 3 table

Two Regional Mental Health Treatment Facilities

One of the major social programs of the 1960s was the development of community mental health centers. As with most early attempts at evaluation, the results were pessimistic. This article reanalyzes one of the earliest, and best-known, evaluations of a community-based treatment facility. Following the conceptual framework of Campbell and his associates, it was found that the various threats to the validity of the findings indicate a consistent and systematic bias against detecting a positive effect for the new mental health center. In light of recent federal legislation mandating formal evaluations, appropriate procedures are discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68090/2/10.1177_0193841X7900300403.pd

In Vitro Photodynamic Therapy with Chlorin e6 Leads to Apoptosis of Human Vascular Smooth Muscle Cells

Percutaneous coronary intervention has become the most common and widely implemented method of heart revascularization. However, the development of restenosis remains the major limitation of this method. Photodynamic therapy (PDT) recently emerged as a new and promising method for the prevention of arterial restenosis. Here the efficacy of chlorin e6 in PDT was investigated in vitro using human vascular smooth muscle cells (TG/HA-VSMCs) as one of the cell types crucial in the development of restenosis. PDT-induced cell death was studied on many levels, including annexin V staining, measurement of the generation reactive oxygen species (ROS) and caspase-3 activity, and assessment of changes in mitochondrial membrane potential and fragmentation of DNA. Photosensitization of TG/HA-VSMCs with a 170 μM of chlorin e6 and subsequent illumination with the light of a 672-nm diode laser (2 J/cm2) resulted in the generation of ROS, a decrease in cell membrane polarization, caspase-3 activation, as well as DNA fragmentation. Interestingly, the latter two apoptotic events could not be observed in photosensitized and illuminated NIH3T3 fibroblasts, suggesting different outcomes of the model of PDT in various types of cells. The results obtained with human VSMCs show that chlorin e6 may be useful in the PDT of aerial restenosis, but its efficacy still needs to be established in an animal model

Evolution of prolate molecular clouds at H II boundaries - II. Formation of BRCs of asymmetrical morphology

A systematic investigation on the evolution of a prolate cloud at an H II boundary is conducted using smoothed particle hydrodynamics in order to understand the mechanism for a variety of irregular morphological structures found at the boundaries of various H II regions. The prolate molecular clouds in this investigation are set with their semimajor axes at inclinations between 0° and 90° to a plane-parallel ionizing radiation flux. A set of four parameters, the number density n, the ratio of major to minor axis γ, the inclination angle Φ and the incident flux FEUV, are used to define the initial state of the simulated clouds. The dependence of the evolution of a prolate cloud under radiation-driven implosion (RDI) on each of the four parameters is investigated. It is found that (i) in addition to the well-studied standard type A, B or C bright-rimmed clouds (BRCs), many other types such as asymmetrical BRCs, filamentary structures and irregular horse-head structures could also be developed at H II boundaries with only simple initial conditions; (ii) the final morphological structures are very sensitive to the four initial parameters, especially to the initial density and the inclination; (iii) the previously defined ionizing radiation penetration depth can still be used as a good indicator of the final morphology. Based on the simulation results, the formation time-scales and masses of the early RDI-triggered star formation from clouds of different initial conditions are also estimated. Finally a unified mechanism for the various morphological structures found in many different H II boundaries is suggested