Investigation into the memory processes that underlie judgments of recency

Judgements of recency (JORs) are decisions about how long ago a repeated item was initially presented. Event-related potentials (ERPs) were acquired in three experiments, alongside behavioural measures, in order to determine the number and nature of memory processes contributing to JORs. In a series of continuous verbal memory tasks (adapted from Yntema & Trask, 1963), participants were presented with a long list of words and for each item participants were required to make an old/new recognition judgement, followed by a numerical JOR. The repetition intervals and JOR response options varied across experiments from between 5 to 35 intervening words. The mid-frontal old/new effect and the left parietal old/new effect were two ERP modulations which varied in a strength-based manner across time and JOR. These bore resemblances to effects reported in previous studies where they were associated with familiarity and recollection memory processes respectively. Late frontal ERP activity was also identified in the experiments and this is discussed in relation to previous theory. A series of behavioural experiments was employed in addition to the ERP studies, which also involved continuous memory tasks. These studies all had 6 different repetition lags and JOR response options which were between 5 and 30 with increments of 5 (adapted from Hintzman, 2003). This research was conducted in order to address further questions about how recollection and familiarity might support JORs under different circumstances. Additional support for the notion that memory processes underpin JORs in a strength-based manner was identified in this behavioural series. The findings in this thesis therefore suggest that JORs are based in part on an assessment of memory strength, and that two memory processes are likely to support memory for recency under some circumstances

Impacts of an extreme precipitation event on dipterocarp mortality and habitat filtering in a Bornean tropical rainforest

The frequency of extreme precipitation events is predicted to increase in some tropical regions in response to global climate change, but the impacts of this form of disturbance on the structure and dynamics of tropical tree communities across heterogeneous landscapes remain understudied. We determined the effects of an extreme precipitation event (EPE) in July 2006 on mortality of dipterocarps on a 68 ha permanent inventory plot in Sepilok Forest Reserve, Sabah. For stems ≥30 cm dbh, 12 of the 15 species of Dipterocarpaceae on this plot have significant positive and/or negative associations to habitats defined by topography and soil type. Short-term mortality induced by the EPE was much greater for individuals growing on the alluvial floodplain (13.7%) than in the mudstone (1.4%) or sandstone (0.0%) habitats, but mortality of dipterocarps did not differ among these habitats in the subsequent 5-yr interval. The likelihood of mortality in response to the EPE was highest for a small group of fast growing dipterocarps that possess low wood density and a strong association to the alluvial forest habitat. This group of species represents a high percentage of dipterocarp individuals but a low proportion of dipterocarp diversity in this habitat. We conclude that disturbance induced by high rainfall events contributes to the episodic nature of tropical forest dynamics, and that increases in the frequency of these events would disproportionately impact low-lying alluvial forest environments and some of the species growing in them

“Artlift” Arts-on-Referral Intervention in UK Primary Care: Updated findings from an ongoing observational study

Background: Arts for health interventions are an accepted option for medical management of mental wellbeing in health care. Updated findings are presented from a prospective longitudinal follow-up (observational) design study of an arts on referral programme in UK general practice, over a 7-year period (2009–2016). Methods: Primary care process and mental wellbeing outcomes were investigated, including progress through the intervention, changes in mental wellbeing, and factors associated with those outcomes. A total of n =1297 patients were referred to an eight or 10-week intervention over a period from 2009 to 2016. Patient sociodemographic information was recorded at baseline, and patient progress (e.g. attendance) assessed throughout the intervention. Results: Of all referrals, 51.7% completed their course of prescribed art (the intervention). Of those that attended, 74.7% engaged with the intervention as rated by the artists leading the courses. A significant increase in wellbeing was observed from pre- to post-intervention (t = −19.29, df =523, P < 0.001, two-tailed) for those that completed and/or engaged. A sub sample (N =103) of these referrals self-reported multi-morbidities. These multiple health care service users were majority completers (79.6%), and were rated as having engaged (81.0%). This group also had a significant increase in well-being, although this was smaller than for the group as a whole (t = −7.38, df =68, P < 0.001). Conclusion: Findings confirm that art interventions can be effective in the promotion of well-being for those that complete, including those referred with multi-morbidity, with significant changes in wellbeing evident across the intervention periods

Active restoration accelerates the carbon recovery of human modified-tropical forests

More than half of all tropical forests are degraded by human impacts, leaving them threatened with conversion to agricultural plantations and risking substantial biodiversity and carbon losses. Restoration could accelerate recovery of aboveground carbon density (ACD), but adoption of restoration is constrained by cost and uncertainties over effectiveness. We report a long-term comparison of ACD recovery rates between naturally regenerating and actively restored logged tropical forests. Restoration enhanced decadal ACD recovery by more than 50%, from 2.9 to 4.4 megagrams per hectare per year. This magnitude of response, coupled with modal values of restoration costs globally, would require higher carbon prices to justify investment in restoration. However, carbon prices required to fulfill the 2016 Paris climate agreement [$40 to$80 (USD) per tonne carbon dioxide equivalent] would provide an economic justification for tropical forest restoration

Topography shapes the structure, composition and function of tropical forest landscapes.

Topography is a key driver of tropical forest structure and composition, as it constrains local nutrient and hydraulic conditions within which trees grow. Yet, we do not fully understand how changes in forest physiognomy driven by topography impact other emergent properties of forests, such as their aboveground carbon density (ACD). Working in Borneo - at a site where 70-m-tall forests in alluvial valleys rapidly transition to stunted heath forests on nutrient-depleted dip slopes - we combined field data with airborne laser scanning and hyperspectral imaging to characterise how topography shapes the vertical structure, wood density, diversity and ACD of nearly 15 km2 of old-growth forest. We found that subtle differences in elevation - which control soil chemistry and hydrology - profoundly influenced the structure, composition and diversity of the canopy. Capturing these processes was critical to explaining landscape-scale heterogeneity in ACD, highlighting how emerging remote sensing technologies can provide new insights into long-standing ecological questions

A prospective service evaluation of acceptance and commitment therapy for patients with refractory epilepsy

Objective: The aims of this service evaluation were to explore the effectiveness of a psychotherapeutic treatment for patients with epilepsy based on the acceptance and commitment therapy (ACT) approach and to assess whether this treatment is likely to be cost-effective. Method: We conducted an uncontrolled prospective study of consecutive patients with refractory epilepsy referred for outpatient psychological treatment to a single psychotherapist because of emotional difficulties related to their seizure disorder. Participants were referred by consultant neurologists, neuropsychologists, or epilepsy nurses, completed a set of validated self-report questionnaires (Short Form - 12 version 2, Generalized Anxiety Disorder - 7, Neurological Disorders Depression Inventory for Epilepsy, Work and Social Adjustment Scale, and Rosenberg Self-Esteem Scale), and reported their seizure frequency at referral, the end of therapy, and six months posttherapy. Patients received a maximum of 20 sessions of one-to-one psychological treatment supported by a workbook. Cost-effectiveness was estimated based on the calculation of quality-adjusted life year (QALY) gains associated with the intervention. Results: Sixty patients completed the prepsychotherapy and postpsychotherapy questionnaires, among whom 41 also provided six-month follow-up data. Patients received six to 20 sessions of psychotherapy (mean = 11.5, S.D. = 9.6). Psychotherapy was associated with significant medium to large positive effects on depression, anxiety, quality of life, self-esteem, and work and social adjustment ( ps < .001), which were sustained six months after therapy. The mean cost of the psychotherapy was £445.6, and, assuming that benefits were maintained for at least six months after the end of therapy, the cost per QALY was estimated to be £11,140 (€14,119, $18,016; the cost per QALY would be half this amount if the benefits lasted one year). Conclusion: The findings of this pilot study indicate that the described psychotherapeutic intervention may be a cost-effective treatment for patients with epilepsy. The results suggest that a randomized controlled trial of the psychotherapy program is justified

Coping with stress: a pilot study of a self-help stress management intervention for patients with epileptic or psychogenic non-epileptic seizures

Purpose: Many patients with epilepsy or psychogenic non-epileptic seizures (PNES) experience high levels of stress. Although psychological interventions have been developed for seizure disorders, few patients can currently access them. We aimed to assess the acceptability and feasibility of a self-help intervention targeting stress in patients with seizures, and to provide preliminary evidence for its effectiveness. Method: Patients were recruited from outpatient neurology clinics and randomised to an immediate intervention group (n=39), who received the intervention at baseline, or a delayed intervention group (n=43), who received the intervention one month post-baseline. Participants completed self-report questionnaires measuring stress (SSSI), anxiety (GAD-7), depression (NDDI-E), quality of life (EQ-5D), seizure severity and frequency (LSSS-3) at baseline, and at one- and two-month follow-up. Participants also provided telephone feedback. The intervention consisted of a self-help stress management workbook based on an integrative stress model framework. Results: Although the rate of participants failing to return follow-up information at two months was approximately 50%, those who completed the trial found the intervention acceptable; with the majority rating it as helpful (63.6%) and that they would recommend it to others with seizures (88.1%). A significant reduction in self-reported stress (p = 0.01) with a medium effect size (dz = 0.51) was observed one-month post-intervention. There were no significant changes in any other measures. Conclusion: The intervention was perceived to be acceptable, safe and helpful by participants. It could be a useful complementary treatment option for reducing stress experienced by patients living with seizure disorders. Further evaluation in a larger trial is warranted

WELLFOCUS PPT – modified positive psychotherapy to improve well-being in psychosis: study protocol for a pilot randomised controlled trial

BACKGROUND: The promotion of well-being is an important goal of recovery oriented mental health services. No structured, evidence-based intervention exists that aims to increase the well-being in people with severe mental illness such as psychosis. Positive psychotherapy (PPT) is a promising intervention for this goal. Standard PPT was adapted for use with people with psychosis in the UK following the Medical Research Council framework for developing and testing complex interventions, resulting in the WELLFOCUS Model describing the intended impact of WELLFOCUS PPT. This study aims to test the WELLFOCUS Model, by piloting the intervention, trial processes, and evaluation strategy. METHODS/DESIGN: This study is a non-blinded pragmatic pilot RCT comparing WELLFOCUS PPT provided as an 11-session group therapy in addition to treatment as usual to treatment as usual alone. Inclusion criteria are adults (aged 18–65 years) with a main diagnosis of psychosis who use mental health services. A target sample of 80 service users with psychosis are recruited from mental health services across the South London and Maudsley NHS Foundation Trust. Participants are randomised in blocks to the intervention and control group. WELLFOCUS PPT is provided to groups by specifically trained and supervised local therapists and members of the research team. Assessments are conducted before randomisation and after the group intervention. The primary outcome measure is well-being assessed by the Warwick-Edinburgh Mental Well-being Scale. Secondary outcomes include good feelings, symptom relief, connectedness, hope, self-worth, empowerment, and meaning. Process evaluation using data collected during the group intervention, post-intervention individual interviews and focus groups with participants, and interviews with trial therapists will complement quantitative outcome data. DISCUSSION: This study will provide data on the feasibility of the intervention and identify necessary adaptations. It will allow optimisation of trial processes and inform the evaluation strategy, including sample size calculation, for a future definitive RCT. TRIAL REGISTRATION: Current Controlled Trials ISRCTN04199273 – WELLFOCUS study: an intervention to improve well-being in people with psychosis, Date registered: 27 March 2013, first participant randomised on 26 April 2013