The identification and psychological treatment of panic disorder in adolescents: a survey of CAMHS clinicians

Background Panic disorder is experienced by around 1% of adolescents, and has a significant impact on social and academic functioning. Preliminary evidence supports the effectiveness of panic disorder specific treatment in adolescents with panic disorder, however panic disorder may be overlooked in adolescents due to overlapping symptoms with other anxiety disorders and other difficulties being more noticeable to others. The aim of this study was to establish what training National Health Service (NHS) Child and Adolescent Mental Health Services (CAMHS) clinicians have received in psychological therapies and panic disorder and how they identify and treat panic disorder in adolescents. Method CAMHS clinicians from a range of professions (n = 427), who were delivering psychological treatments to children and adolescents with anxiety disorders, participated. They completed a cross-sectional, online survey, including a vignette describing an adolescent with panic disorder, and were asked to identify the main diagnosis or presenting problem. Results Less than half the clinicians (48.6%) identified panic disorder or panic symptoms as the main presenting problem from the vignette. The majority of clinicians suggested CBT would be their treatment approach. However, few identified an evidence-based treatment protocol for working with young people with panic disorder. Almost half the sample had received no training in cognitive behaviour therapy (CBT) and around a fifth had received no training in delivering psychological treatments. Conclusions Only half of CAMHS clinicians identified panic disorder from a vignette and although CBT treatments are widely offered, only a minority of adolescents with panic disorder are receiving treatments developed for, and evaluated with young people with panic disorder. There is a vital need for clinician training, the use of tools that aid identification and the implementation of evidence-based treatments within CAMHS

A case study of asthma care in school age children using nurse-coordinated multidisciplinary collaborative practices

Aim: To describe the role of school nursing in leading and coordinating a multidisciplinary networked system of support for children with asthma, and to analyze the strengths and challenges of undertaking and supporting multiagency interprofessional practice. Background: The growth of networked and interprofessional collaborations arises from the recognition that a number of the most pressing public health problems cannot be addressed by single-discipline or -agency interventions. This paper identifies the potential of school nursing to provide the vision and multiagency leadership required to coordinate multidisciplinary collaboration. Method: A mixed-method single-case study design using Yin’s approach, including focus groups, interviews, and analysis of policy documents and public health reports. Results: A model that explains the integrated population approach to managing school-age asthma is described; the role of the lead school nurse coordinator was seen as critical to the development and sustainability of the model. Conclusion: School nurses can provide strategic multidisciplinary leadership to address pressing public health issues. Health service managers and commissioners need to understand how to support clinicians working across multiagency boundaries and to identify how to develop leadership skills for collaborative interprofessional practice so that the capacity for nursing and other health care professionals to address public health issues does not rely on individual motivation. In England, this will be of particular importance to the commissioning of public health services by local authorities from 2015

Initial radio-frequency gas heating experiments to simulate the thermal environment in a nuclear light bulb reactor

Initial radio frequency gas heating experiments to simulate thermal environment in nuclear light bulb reacto

Update: Accurate Determinations of alpha_s from Realistic Lattice QCD

We use lattice QCD simulations, with MILC configurations (including vacuum polarization from u, d, and s quarks), to update our previous determinations of the QCD coupling constant. Our new analysis uses results from 6 different lattice spacings and 12 different combinations of sea-quark masses to significantly reduce our previous errors. We also correct for finite-lattice-spacing errors in the scale setting, and for nonperturbative chiral corrections to the 22 short-distance quantities from which we extract the coupling. Our final result is alpha_V(7.5GeV,nf=3) = 0.2120(28), which is equivalent to alpha_msbar(M_Z,n_f=5)= 0.1183(8). We compare this with our previous result, which differs by one standard deviation.Comment: 12 pages, 2 figures, 4 table

Differences in peripheral noradrenergic function among actively drinking and abstinent alcohol-dependent individuals.

We examined whether excessive alcohol consumption was related to changes in plasma levels of noradrenaline (NA) and whether these changes recover following abstinence. We also explored whether there were differences in NA levels between Type I and Type II alcoholics and controls during active drinking and abstinence. Plasma concentrations of NA were determined in (1) 27 Caucasian men with alcohol dependence who were regularly drinking (active drinkers) within 24 hours of hospitalization, (2) 29 Caucasian alcohol-dependent men who were in remission (abstinent for a minimum of three months), and (3) 28 race- and gender-matched healthy controls. NA concentrations were significantly higher in actively drinking alcohol-dependent subjects compared to those in remission and controls. While Type I and Type II alcoholic individuals differed across clinical measures, NA levels were similar in the two subtypes. Both subtypes showed an elevation in NA levels during active drinking compared to controls, but NA levels did not differ between the two subtypes and controls during remission. The findings indicate that chronic exposure to alcohol may lead to disturbances in NA activity that may manifest in early abstinence. However, the changes in NA activity appears to normalize after a longer period of abstinence. Alterations in NA activity do not seem to be specific for Type I or Type II subtypes of alcoholism

The impact of dredging on public grounds in the Pocomoke Sound area during the 1978-1979 oyster season

The areas opened to dredging in Pocomoke Sound by the Virginia Marine Resources Commission (VMRC} were studied by the Virginia Institute of Marine Science (VIMS} to determine the effects of dredging upon the oyster populations

The Present and Potential Productivity of the Baylor Grounds in Virginia - Volume II: James River, Pocomoke and Tangier Sounds, The Bayside and Seaside of the Eastern Shore, and the Virginia Tributaries of the Potomac River (Coan and Yeocomico Rivers, and Lower Machodoc and Nomini Creeks)

Section 1: The Baylor bottoms in the James River Section 2: The Baylor bottoms in Pocomoke and Tangier Sounds, Pungoteague, Occohannock and Nassawadox Creeks Section 3: The Baylor grounds of the Potomac River tributaries in Virginia (Nomini and lower Machodoc creeks and the Coan and Yeocomico Rivers) Section 4: The Baylor bottoms on the seaside of the Eastern Shore Appendix: Charts of Baylor ground