The Acceptability of Internet-Based Treatment and Characteristics of an Adult Sample with Obsessive Compulsive Disorder: An Internet Survey

Background: Obsessive-compulsive disorder (OCD) is a disabling anxiety disorder, but most individuals delay seeking treatment. Internet-based cognitive behavioural therapy (iCBT) is an innovative service delivery method that may help to improve access to care, but the acceptability to consumers of such programs has not yet been established. Methodology: People with symptoms of OCD were invited to complete an online survey enquiring about demographic characteristics, symptom severity, and acceptability of Internet-based treatment. Demographic and symptom severity data were compared with people with OCD identified in a national epidemiological survey and with a sample of patients with OCD from a specialist outpatient anxiety clinic. Participants: 129 volunteers to an online Internet survey, 135 patients at a specialist anxiety disorders outpatient clinic, and 297 cases identified in a national epidemiological survey. Main Measures: Demographic characteristics, and severity of symptoms as measured by the Kessler 10-Item scale, the 12-item World Health Organisation Disability Assessment Schedule - Second Edition and the Yale Brown Obsessive Compulsive Scale - Self Report Version. Principal Findings: The Internet sample was similar demographically but reported more severe symptoms than the comparison groups, although had similar severity of symptoms of OCD compared with other clinical samples reported in the literature. Participants reported Internet-based treatment for OCD would be highly acceptable. Conclusions: Internet-based treatment may reduce barriers to accessing treatment to people with OCD. Individuals in this study were similar demographically to other samples and had similar severity of symptoms as those identified in other clinical samples, suggesting that Internet-based treatment using techniques employed in face-to-face treatment may be effective in this group. Internet-based treatments for OCD need to be developed and evaluated

Quantitative distribution pattern of Oligocene and Miocene calcareous nannofossils from the western equatorial Indian Ocean.

Biostratigraphically useful nannofossil markers were investigated by means of quantitative methods in Oligocene through middle Miocene sediments from the western tropical Indian Ocean. In the Oligocene a distinct shift in dominance between Sphenolithus predistentus and Sphenolithus distentus represents a better marker event than the first occurrence (FO) of the latter for recognition of the CP17/CP18 boundary. Similarly, the shift in dominance between S. distentus and Sphenolithus ciperoensis at 28.8 Ma provides a more reliable indication for the CP19a/CP19b (NP24/NP25) boundary than the last occurrence (LO) of the former species, which may occur as late as 27.4 Ma. Because it is rare in the critical interval and occurs well within the early Miocene, the LO of Helicosphaera recta (NP25/NN1 boundary) provides unreliable biostratigraphic information. In the Miocene, an acme interval of Sphenolithus delphix that ranges in age from 23.6 to 24.7 Ma, is an important addition to the poorly resolved biostratigraphy of the early Miocene. The midpoint of this short acme interval of S. delphix would form a suitable criterion for replacing the formal CNla/CNlb boundary definition (end acme Cyclicargolithus abisectus), which has never been defined quantitatively. No overlap in the ranges of Sphenolithus belemnos and Sphenolithus heteromorphus was observed. The LO of Coronocyclus nitescens provides a more reliable biostratigraphic signal than the FO of Discoaster kugleri for subdivision of the CN5 (NN6-NN7) interval. Biometric analysis of Calcidiscus placolith size revealed a clear bimodal distribution into forms larger or smaller than 10 micron, in sediments of late Pliocene-early Pleistocene age. The middle Miocene populations, however, are clearly unimodal. Morphotypes > 11 micron appear rather distinctly in Subzone CN5b between about 11 and 12 Ma

Meibomian Gland Morphology is a Sensitive Early Indicator of Meibomian Gland Dysfunction

Purpose To investigate the relationship between meibomian gland (MG) morphology and clinical dry eye tests in patients with meibomian gland dysfunction (MGD). Design Cross-sectional study. Subjects Total 538 MGD patients and 21 healthy controls. Methods MG loss on meibography images of upper (UL) and lower lids (LL) was graded on a scale of 0 (lowest degree of MG loss) to 3. MG length, thickness, and interglandular space in the UL were measured. Clinical tests included meibum expression and quality, tear film break-up time, ocular staining, osmolarity, Schirmer I, blink interval timing, and Ocular Surface Disease Index (OSDI) questionnaire. Results Mean UL and LL meibogrades were significantly higher in MGD patients compared to controls (P < .001 for UL and LL). The sensitivity and specificity of the meibograde as a diagnostic parameter for MGD was 96.7% and 85%, respectively. Schirmer I was significantly increased in MGD patients with meibograde 1 compared to patients with meibograde 0, 2, and 3 in the UL (P < .05). MG thickness increased with higher meibograde (P < .001). MG morphology correlated significantly but weakly with several clinical parameters (P < .05). OSDI did not correlate with any MG morphologic parameter. Conclusions Grading of MG loss using meibograde effectively diagnoses MGD. Compensatory mechanisms such as increased aqueous tear production and dilation of MGs make early detection of MGD difficult by standard clinical measures of dry eye, whereas morphologic analysis of MGs reveals an early stage of MGD, and therefore represents a complementary clinical parameter with diagnostic potential

Spa therapy in dermatology

Spa therapy constitutes the use of mineral springs and thermal mud to soothe and heal various ailments. Like the mineral springs, seas and oceans are also important centers for spa therapy of which the most important is Dead Sea (DS). DS has been famous for thousands of years for its miraculous curative and cosmetic properties. Intensive research is going on using DS minerals in a wide range of dermatological conditions especially psoriasis, atopic dermatitis, vitiligo and other eczemas and several papers have been published in various international and pharmacological journals