Skill acquisition in parents with an intellectual disability : the effectiveness of in-home behavioural parent training

Little research has been conducted focusing on parent training strategies aimed at teaching parents with an intellectual disability to implement strategies to decrease their child's problem behaviour and increase appropriate behaviours. This study aimed to do two things. First, to examine the effectiveness of an enhanced assessment-based BPT intervention that was implemented by parents with an intellectual disability with children with problem behaviour. Second, the current study also aimed to test the effectiveness of the parent training package used to teach parents to implement the intervention strategies. Importantly, in an attempt to identify the training condition, or combination of conditions, most needed to achieve behaviour change, individual conditions of a multi-condition parent training package were additively introduced during parent training based on the degree of intrusiveness in the target routine combined with the amount of structure required by the teaching strategy. Five parents were taught to implement a functional assessment driven intervention plan aimed at increasing their child's appropriate behaviour and decreasing their problem behaviour during a valued family routine. In order to establish the combination of parent training strategies that were sufficient to teach parents to effectively implement the intervention plan, a series of parent training strategies were introduced in a planned way. The strategies included role-play, verbal instruction, verbal instruction plus feedback, coaching and video-feedback. Results showed that for all parents skill acquisition did not occur until the final phase, video-feedback. Successful implementation of the intervention resulted in a corresponding increase in child appropriate behaviour and decrease in child problem behaviour. In addition to that, parents rated the social validity and contextual fit of the inte rvention highly

Terminology for psychogenic nonepileptic seizures:Making the case for "functional seizures"

PURPOSE: The purpose of the study was to review the literature on the terminologies for psychogenic nonepileptic seizures (PNES) and make a proposal on the terminology of this condition. This proposal reflects the authors' own opinions.METHODS: We systematically searched MEDLINE (accessed from PubMed) and EMBASE from inception to October 10, 2019 for articles written in English with a main focus on PNES (with or without discussion of other functional neurological disorders) and which either proposed or discussed the accuracy or appropriateness of PNES terminologies.RESULTS: The search strategy reported above yielded 757 articles; 30 articles were eventually included, which were generally of low quality. "Functional seizures" (FS) appeared to be an acceptable terminology to name this condition from the perspective of patients. In addition, FS is a term that is relatively popular with clinicians.CONCLUSION: From the available evidence, FS meets more of the criteria proposed for an acceptable label than other popular terms in the field. While the term FS is neutral with regard to etiology and pathology (particularly regarding whether psychological or not), other terms such as "dissociative", "conversion", or "psychogenic" seizures are not. In addition, FS can potentially facilitate multidisciplinary (physical and psychological) management more than other terms. Adopting a universally accepted terminology to describe this disorder could standardize our approach to the illness and facilitate communication between healthcare professionals, patients, their families, carers, and the wider public.</p

A shallow earthquake swarm close to hydrocarbon activities: discriminating between natural and induced causes for the 2018–19 Surrey, UK earthquake sequence

Earthquakes induced by subsurface industrial activities are a globally emotive issue, with a growing catalogue of induced earthquake sequences. However, attempts at discriminating between natural and induced causes, particularly for anomalously shallow seismicity, can be challenging. An earthquake swarm during 2018–19 in south-east England with a maximum magnitude of ML 3.2 received great public and media attention because of its proximity to operating oilfields. It is therefore vital and timely to provide a detailed characterisation of the earthquake sequence at present, and to decide based on current evidence, whether the earthquakes were likely natural or induced. We detected 168 low-magnitude earthquakes and computed detailed source parameters of these events. Most earthquakes occurred at a shallow depth of 2.3 km, >1 km deeper than the geological formations targeted by the oilfields, and laterally >3 km away from the drill-sites. We combine the east-west trending cluster of the seismicity with 2-D seismic reflection profiles to find the causative fault system for the earthquakes. A b-value close to unity and strike-slip faulting mechanisms are consistent with tectonic reactivation along a pre-existing fault. Overall, we find no indicators in the earthquake parameters that would strongly suggest an induced source. Nor do we find any clear trends between seismicity and drilling activities based on operational logs provided by the operators. Injected volumes are near-zero and monthly production amounts are many orders of magnitude smaller than other reported cases of extraction-induced seismicity. On balance, and based on the available evidence, we find it currently unlikely that nearby industrial activities induced the seismic swarm. Most likely, the Surrey earthquakes offer a uniquely detailed insight into shallow seismicity within sedimentary basins. Nevertheless, self-reporting of injection and production times and volumes by operators, and the lack of easily- and publicly-available oilfield operational data continues to be a point of concern for local residents

Spatial migration of temporal earthquake clusters driven by the transfer of differential stress between neighbouring fault/shear-zone structures

Uncertainty concerning the processes responsible for slip-rate fluctuations associated with temporal clustering of surface faulting earthquakes is a fundamental, unresolved issue in tectonics, because strain-rates accommodated by fault/shear-zone structures are the key to understanding the viscosity structure of the crust and seismic hazard. We constrain the timing and amplitude of slip-rate fluctuations that occurred on three active normal faults in central Italy over a time period of 20–30 kyrs, using in situ 36Cl cosmogenic dating of fault planes. We identify five periods of rapid slip on individual faults lasting a few millennia, separated time periods of up to 10 millennia with low or zero slip-rate. The rapid slip pulses migrated across the strike between the faults in two waves from SW to NE. We replicate this migration with a model where rapid slip induces changes in differential stress that drive changes in strain-rate on viscous shear zones that drive slip-rate variability on overlying brittle faults. Earthquakes increase the differential stress and strain-rate on underlying shear zones, which in turn accumulate strain, re-loading stress onto the overlying brittle fault. This positive feedback produces high strain-rate episodes containing several large magnitude surface faulting earthquakes (earthquake clusters), but also reduce the differential stress on the viscous portions of neighbouring fault/shear-zones slowing the occurrence of large-magnitude surface faulting earthquakes (earthquake anticlusters). Shear-zones on faults experiencing anticlusters continue to accumulate viscous strain at a lowered rate, and eventually this loads the overlying brittle fault to failure, initiating a period of rapid slip through the positive feedback process described above, and inducing lowered strain-rates onto neighbouring fault/shear-zones. We show that these patterns of differential stress change can replicate the measured earthquake clustering implied by the 36Cl data. The stress changes are related to the fault geometry in terms of distance and azimuth from the slipping structure, implying that (a) strain-rate and viscosity fluctuations for studies of continental rheology, and (b) slip-rates for seismic hazard purposes are to an extent predictable given knowledge of the fault system geometry

Out of phase Quaternary uplift-rate changes reveal normal fault interaction, implied by deformed marine palaeoshorelines

We have mapped and constrained the timing of tectonically deformed uplifted Late Quaternary palaeoshorelines in the Messina Strait, southern Italy, an area above a subduction zone containing active normal faults. The palaeoshorelines are preserved from up to thirteen Late Quaternary sea-level highstands, providing a record of the deformation over this timescale (~500 ka) for the Messina-Taormina Fault, the Reggio Calabria Fault and the Armo Fault. The palaeoshorelines reveal spatial patterns of uplift through time along the strike of these normal faults, and, given the across strike arrangement of the faults, also reveal how the contribution of each fault to the regional strain-rate progressed through time. The results reveal that the uplift rates mapped within the fault hangingwalls and footwalls were not constant through time, with a marked change in the location of strain accumulation at ~50 ka. The uplift rates, once converted into throw-rates, imply that the three faults comprised similar throw-rates prior to ~50 ka (in the range 0.77–0.96 mm/yr), with the Armo and Reggio Calabria faults then switching to lower rates (0.32 mm/yr and 0.33 mm/yr respectively), whilst the Messina-Taormina Fault accelerated to 2.34 mm/yr. The regional extension rate, gained by summing the implied heave rates across the three faults, was maintained through time despite this re-organisation of local strain accumulation at ~50 ka. We explain these out-of-phase fault throw-rate changes during the constant-rate regional extension conditions as due to interactions between these upper plate normal faults. We finally discuss how fault throw-rates changing through time may affect a long-term seismic hazard assessment within active normal fault systems

Editorial: Fifty Campbell systematic reviews relevant to the policy response to COVID-19

This is the final version. Available on open access from Wiley via the DOI in this recordNational Institute for Health Research (NIHR

Surface faulting during the August 24, 2016, central Italy earthquake (Mw 6.0): Preliminary results

We present some preliminary results on the mapping of coseismically-induced ground ruptures following the Aug. 24, 2016, Central Italy earthquake (Mw 6.0). The seismogenic source, as highlighted by InSAR and seismological data, ruptured across two adjacent structures: the Mt. Vettore and Laga faults. We collected field data on ground breaks along the whole deformed area and two different scenarios of on-fault coseismic displacement arise from these observations. To the north, along the Mt. Vettore fault, surface faulting can be mapped quite continuously along a well-defined fault strand while such features are almost absent to the south, along the Laga fault, where flysch-like marly units are present. A major lithological control affects the surface expression of faulting, resulting in a complex deformation pattern

Time series analysis of age related cataract hospitalizations and phacoemulsification

BACKGROUND: Cataract surgery remains a commonly performed elective surgical procedure in the aging and the elderly. The purpose of this study was to utilize time series methodology to determine the temporal and seasonal variations and the strength of the seasonality in age-related (senile) cataract hospitalizations and phacoemulsification surgeries. METHODS: A retrospective, cross-sectional time series analysis was used to assess the presence and strength of seasonal and temporal patterns of age-related cataract hospitalizations and phacoemulsification surgeries from April 1, 1991 to March 31, 2002. Hospital admission rates for senile cataract (n = 70,281) and phacoemulsification (n = 556,431) were examined to determine monthly rates of hospitalization per 100,000 population. Time series methodology was then applied to the monthly aggregates. RESULTS: During the study period, age-related cataract hospitalizations in Ontario have declined from approximately 40 per 100,000 to only one per 100,000. Meanwhile, the use of phacoemulsification procedures has risen dramatically. The study found evidence of biannual peaks in both procedures during the spring and autumn months, and summer and winter troughs. Statistical analysis revealed significant overall seasonal patterns for both age-related cataract hospitalizations and phacoemulsifications (p < 0.01). CONCLUSION: This study illustrates the decline in age-related cataract hospitalizations in Ontario resulting from the shift to outpatient phacoemulsification surgery, and demonstrates the presence of biannual peaks (a characteristic indicative of seasonality), in hospitalization and phacoemulsification during the spring and autumn throughout the study period

A database of the coseismic effects following the 30 October 2016 Norcia earthquake in Central Italy

We provide a database of the coseismic geological surface effects following the Mw 6.5 Norcia earthquake that hit central Italy on 30 October 2016. This was one of the strongest seismic events to occur in Europe in the past thirty years, causing complex surface ruptures over an area of >400 km 2. The database originated from the collaboration of several European teams (Open EMERGEO Working Group; about 130 researchers) coordinated by the Istituto Nazionale di Geofisica e Vulcanologia. The observations were collected by performing detailed field surveys in the epicentral region in order to describe the geometry and kinematics of surface faulting, and subsequently of landslides and other secondary coseismic effects. The resulting database consists of homogeneous georeferenced records identifying 7323 observation points, each of which contains 18 numeric and string fields of relevant information. This database will impact future earthquake studies focused on modelling of the seismic processes in active extensional settings, updating probabilistic estimates of slip distribution, and assessing the hazard of surface faulting