Effectiveness of Group Behavioural Activation for Depression: A Pilot Study.

BACKGROUND: The evidence base for behavioural activation (BA) is mainly grounded in the individual delivery method, with much less known about the impact of group delivery. AIMS: To conduct a pilot study of behavioural activation in groups (BAG) for depression delivered in a routine service setting, in order to explore acceptability, effectiveness and predictors of outcome. METHODS: The manualized group treatment format was delivered in a Primary Care mental health setting, at step three of an Improving Access to Psychological Therapies (IAPT) service. BAG was facilitated by cognitive behavioural psychotherapists, and outcome measures (depression, anxiety and functional impairment) were taken at each session. Seventy-three participants were referred and treated within nine groups. RESULTS: BAG was an acceptable treatment generating a low drop-out rate (7%). Significant pre-post differences were found across all measures. There was a moderate to large depression effect size (d + = 0.74), and 20% met the criteria for a reliable recovery in depression. Greater severity of initial depression and attendance of at least four BAG sessions predicted better outcomes. CONCLUSIONS: BAG appears to be an effective depression treatment option that shows some clinical promise. Further larger and more controlled studies are nevertheless required

Regional Brain Morphometry Predicts Memory Rehabilitation Outcome after Traumatic Brain Injury

Cognitive deficits following traumatic brain injury (TBI) commonly include difficulties with memory, attention, and executive dysfunction. These deficits are amenable to cognitive rehabilitation, but optimally selecting rehabilitation programs for individual patients remains a challenge. Recent methods for quantifying regional brain morphometry allow for automated quantification of tissue volumes in numerous distinct brain structures. We hypothesized that such quantitative structural information could help identify individuals more or less likely to benefit from memory rehabilitation. Fifty individuals with TBI of all severities who reported having memory difficulties first underwent structural MRI scanning. They then participated in a 12 session memory rehabilitation program emphasizing internal memory strategies (I-MEMS). Primary outcome measures (HVLT, RBMT) were collected at the time of the MRI scan, immediately following therapy, and again at 1-month post-therapy. Regional brain volumes were used to predict outcome, adjusting for standard predictors (e.g., injury severity, age, education, pretest scores). We identified several brain regions that provided significant predictions of rehabilitation outcome, including the volume of the hippocampus, the lateral prefrontal cortex, the thalamus, and several subregions of the cingulate cortex. The prediction range of regional brain volumes were in some cases nearly equal in magnitude to prediction ranges provided by pretest scores on the outcome variable. We conclude that specific cerebral networks including these regions may contribute to learning during I-MEMS rehabilitation, and suggest that morphometric measures may provide substantial predictive value for rehabilitation outcome in other cognitive interventions as well

The Case for Probe-class NASA Astrophysics Missions

Astrophysics spans an enormous range of questions on scales from individual planets to the entire cosmos. To address the richness of 21st century astrophysics requires a corresponding richness of telescopes spanning all bands and all messengers. Much scientific benefit comes from having the multi-wavelength capability available at the same time. Most of these bands,or measurement sensitivities, require space-based missions. Historically, NASA has addressed this need for breadth with a small number of flagship-class missions and a larger number of Explorer missions. While the Explorer program continues to flourish, there is a large gap between Explorers and strategic missions. A fortunate combination of new astrophysics technologies with new, high capacity, low dollar-per-kg to orbit launchers, and new satellite buses allow for cheaper missions with capabilities approaching strategic mission levels. NASA has recognized these developments by calling for Probe-class mission ideas for mission studies, spanning most of the electromagnetic spectrum from GeV gamma-rays to the far infrared, and the new messengers of neutrinos and ultra-high energy cosmic rays. The key insight from the Probes exercise is that order-of-magnitude advances in science performance metrics are possible across the board for initial total cost estimates in the range 500M-1B dollars