Gravitational shear, flexion, and strong lensing in Abell 1689

We present a gravitational lensing analysis of the galaxy cluster Abell 1689, incorporating measurements of the weak shear, flexion, and strong lensing induced in background galaxies. This is the first time that a shapelet technique has been used to reconstruct the distribution of mass in this cluster and the first time that a flexion signal has been measured using cluster members as lenses. From weak shear measurements alone, we generate a nonparametric mass reconstruction, which shows significant substructure corresponding to groups of galaxies within the cluster. In addition, our galaxy-galaxy flexion signal demonstrates that the cluster galaxies can be well fit by a singular isothermal sphere model with a characteristic velocity dispersion of σv = (295 ± 40) km s^(-1). We identify a major, distinct dark matter clump, offset by 40 h^(-1) kpc from the central cluster members, which was not apparent from shear measurements alone. This secondary clump is present in a parametric mass reconstruction using flexion data alone, and its existence is suggested in a nonparametric reconstruction of the cluster using a combination of strong and weak lensing. As found in previous studies, the mass profile obtained by combining weak and strong lensing data shows a much steeper profile than that obtained from only weak lensing data

Family Planning Targets and Quality of Services: Workers' Perspectives and Dilemmas

This paper uses data from in-depth group interviews with family planning workers in Bangladesh to demonstrate both the dysfunctional influence of family planning targets on quality of care as well as the strong connection between targets and the manage ment system. The findings show that the presence of targets influenced the advice and information workers provided, pushing them towards long-term methods such as steril isation and the IUD rather than helping clients select methods most suited to their needs. The paper then shows the connection between the target system and the struc ture of official and unofficial incentives, the pattern of supervision, the system of accountability and a hierarchically organised and gender-biased organisational cul ture. The authors argue that unless these underlying managerial determinants of qual ity of care are addressed, the hope for reaching the goals of the International Conference on Population and Development (ICPD) will remain illusory.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/69103/2/10.1177_097206349900100206.pd

CT and ultrasound in abscess detection at specific anatomic sites: A study of 198 patients

Records of 902 patients with possible abdominal abscess were reviewed and of these 198 had abscesses on at least one occasion imaged either with ultrasound (US) or computed tomography (CT). There were 235 episodes of either one or simultaneous multiple abscesses. Sensitivities of CT and US were analyzed according to anatomic site. The nature of errors made was tabulated. CT was significantly more sensitive than US for the detection of abdominal abscess. Causes of CT and US error in abscess detection are discussed, and recommendations regarding choice of exam and means of improving performance are made.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/26859/1/0000424.pd

Invasive thyroglossal duct cyst papillary carcinoma: a case report

<p>Abstract</p> <p>Introduction</p> <p>A thyroglossal duct cyst is the most common congenital anomaly of the thyroid gland and midline masses in childhood (70% abnormality in childhood, 7% in adult). Carcinomas arising from a thyroglossal duct cyst are rare (only 1% of thyroglossal duct cyst cases) and characterized by relatively non-aggressive behavior and rare lymphatic spread. They are also diagnosed mostly during the third and fourth decades of life. About 85% to 92% of all thyroglossal duct cyst carcinomas are papillary carcinomas.</p> <p>Case presentation</p> <p>We present the case of a 44-year-old Iranian woman with Cacausian ethnicity with a painless anterior neck mass that appeared gradually over three months. She had a history of frequent painful swelling of the anterior part of her neck, which subsided with antibiotic therapy. Thyroid functional tests were normal and a thyroid scinitigraphy showed a cold nodule in the left lobe of her thyroid. A computed tomography scan revealed a large, heterogeneous enhancing soft tissue mass with cystic components in the midline of the anterior neck space. This extended from the base of the tongue,(completely separated from its muscles, to the inferior aspect of the thyroid gland and showed the destruction of the hyoid bone and the thyroid cartilage. The diagnosis of a thyroglossal duct cyst with malignant transformation was maintained. A fine needle aspiration revealed papillary carcinoma.</p> <p>Conclusion</p> <p>This patient's case is presented because of its rare, aggressive, and invasive nature and rare and unusual manifestation, as well as its rapid increase in size, the destruction of the hyoid bone, chondrolysis of the thyroid cartilage, lymph adenopathy and the existence of a cold nodule in the thyroid gland.</p

Practice-Driven Evaluation of a Multi-layered Psychosocial Care Package for Children in Areas of Armed Conflict

Psychosocial and mental health service delivery frameworks for children in low-income countries are scarce. This paper presents a practice-driven evaluation of a multi-layered community-based care package in Burundi, Indonesia, Sri Lanka and Sudan, through a set of indicators; (a) perceived treatment gains; (b) treatment satisfaction; (c) therapist burden; (d) access to care; (e) care package costs. Across four settings (n = 29,292 children), beneficiaries reported high levels of client satisfaction and moderate post-treatment problem reductions. Service providers reported significant levels of distress related to service delivery. Cost analyses demonstrated mean cost per service user to vary from 3.46 to 17.32 € depending on country and specification of costs. The results suggest a multi-layered psychosocial care package appears feasible and satisfactory in reaching out to substantial populations of distressed children through different levels of care. Future replication should address therapist burden, cost reductions to increase sustainability and increase evidence for treatment efficacy

Delivering stepped care: an analysis of implementation in routine practice

addresses: Mood Disorders Centre, University of Exeter, Exeter, EX4 4QG, UK. [email protected]: PMCID: PMC3283464types: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't© 2012 Richards et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.In the United Kingdom, clinical guidelines recommend that services for depression and anxiety should be structured around a stepped care model, where patients receive treatment at different 'steps,' with the intensity of treatment (i.e., the amount and type) increasing at each step if they fail to benefit at previous steps. There are very limited data available on the implementation of this model, particularly on the intensity of psychological treatment at each step. Our objective was to describe patient pathways through stepped care services and the impact of this on patient flow and management

Looking both ways

On the occasion of the 25th anniversary of the journal, Psychotherapy Research, three former editors first look back at: (i) the controversial persistence of the Dodo verdict (i.e., the observation that all bona fide therapies seem equally effective); (ii) the connection between process and outcome; (iii) the move toward methodological pluralism; and (iv) the politicization of the field around evidence-based practice and treatment guidelines. We then look forward to the next 25 years, suggesting that it would be promising to focus on three areas: (i) systematic theory-building research; (ii) renewed attention to fine-grained study of therapist techniques; and (iii) politically expedient research on the outcomes of marginalized or emerging therapies

Self-help interventions for anxiety disorders: An overview.

Anxiety disorders are highly prevalent and are associated with a marked impairment in quality of life and a huge economic cost to society. Unfortunately, a considerable number of people who struggle with anxiety do not seek or receive adequate treatment. Self-help interventions have been proposed to constitute a relatively cheap, effective, efficient, and low-threshold intervention for anxiety disorders. This paper offers a critical discussion of their advantages and disadvantages and the evidence for their effectiveness. We conclude that guided self-help can play a major role in mental health care for patients with anxiety disorders. However, several research questions need to be answered before broad-scale dissemination is possible. The Internet will continue to play a prominent role in the further development of this field of research and clinical practice

Tectonic structure, evolution, and the nature of oceanic core complexes and their detachment fault zones (13°20′N and 13°30′N, Mid Atlantic Ridge)

Microbathymetry data, in situ observations, and sampling along the 138200N and 138200N oceanic core complexes (OCCs) reveal mechanisms of detachment fault denudation at the seafloor, links between tectonic extension and mass wasting, and expose the nature of corrugations, ubiquitous at OCCs. In the initial stages of detachment faulting and high-angle fault, scarps show extensive mass wasting that reduces their slope. Flexural rotation further lowers scarp slope, hinders mass wasting, resulting in morphologically complex chaotic terrain between the breakaway and the denuded corrugated surface. Extension and drag along the fault plane uplifts a wedge of hangingwall material (apron). The detachment surface emerges along a continuous moat that sheds rocks and covers it with unconsolidated rubble, while local slumping emplaces rubble ridges overlying corrugations. The detachment fault zone is a set of anostomosed slip planes, elongated in the alongextension direction. Slip planes bind fault rock bodies defining the corrugations observed in microbathymetry and sonar. Fault planes with extension-parallel stria are exposed along corrugation flanks, where the rubble cover is shed. Detachment fault rocks are primarily basalt fault breccia at 138200N OCC, and gabbro and peridotite at 138300N, demonstrating that brittle strain localization in shallow lithosphere form corrugations, regardless of lithologies in the detachment zone. Finally, faulting and volcanism dismember the 138300N OCC, with widespread present and past hydrothermal activity (Semenov fields), while the Irinovskoe hydrothermal field at the 138200N core complex suggests a magmatic source within the footwall. These results confirm the ubiquitous relationship between hydrothermal activity and oceanic detachment formation and evolution