An exploration into the client at the heart of therapy : a qualitative perspective

Over 50 years ago Eysenck challenged the existing base of research into psychotherapy. Since that time, a large number of investigations have been conducted to verify the efficacy of therapy. Recently however, an increasing number of studies have cast new doubts on this research base. Instead of therapy being a function of the therapist, it is now becoming ever more apparent that the client plays a prime role in the therapeutic process. The qualitative studies presented in this paper provide some examples of research that demonstrates that clients are actively involved in their therapy, even making counselling work despite their counsellor. These studies suggest that clients may not experience therapy as beneficially as traditional outcome studies indicate. This raises a new challenge to researchers to more fully explore the client's experience of therapy, a challenge to which qualitative methods of inquiry would appear well suited

Elementary Derivation of the Chiral Anomaly

An elementary derivation of the chiral gauge anomaly in all even dimensions is given in terms of noncommutative traces of pseudo-differential operators.Comment: Minor errors and misprints corrected, a reference added. AmsTex file, 12 output pages. If you do not have preloaded AmsTex you have to \input amstex.te

Drivers of Pasture Growth in Perennial Ryegrass Pastures in Northern New Zealand Dairy Pastures

The critical importance of pasture production to New Zealand’s economic performance has been widely recognised. However, a number of critical issues have been identified that limit dairy industry growth, including sub-optimal pasture condition and poor pasture persistence. Dairy farm systems in the Waikato and Bay of Plenty provinces in the upper North Island of New Zealand are predominantly pasture-based, with a temperate climate and they represent around 30% of New Zealand’s total number of dairy farms (LIC and DairyNZ, 2012). This project was established to quantify pasture performance and identify factors that drive that performance. We established a network of on-farm trials where case studies of pasture renewal practices and outcomes were developed. Ten farms in each province were monitored for three consecutive years – four paddocks from each province are considered here

Evaluation of waist-to-height ratio to predict 5 year cardiometabolic risk in sub-Saharan African adults

Simple, low-cost central obesity measures may help identify individuals with increased cardiometabolic disease risk, although it is unclear which measures perform best in African adults. We aimed to: 1) cross-sectionally compare the accuracy of existing waist-to-height ratio (WHtR) and waist circumference (WC) thresholds to identify individuals with hypertension, pre-diabetes, or dyslipidaemia; 2) identify optimal WC and WHtR thresholds to detect CVD risk in this African population; and 3) assess which measure best predicts 5-year CVD riskPeer reviewedFinal Accepted Versio

Association of specific chromosome alterations with tumour phenotype in posterior uveal melanoma

Posterior uveal melanomas have recurrent alterations of chromosomes 1, 3, 6 and 8. In particular, changes of chromosomes 3 and 8 occur in association, appear to characterize those tumours with a ciliary body component, and have been shown to be of prognostic significance. The relevance of other chromosome alterations is less certain. We have performed cytogenetic analysis on 42 previously untreated primary posterior uveal melanomas. Of interest was the observation that as tumour size increased the involvement of specific chromosome changes, and the amount of chromosome abnormalities likewise increased. Loss, or partial deletions, of the short arm of chromosome 1 were found to associate with larger ciliary body melanomas; typically, loss of the short arm resulted from unbalanced translocations, the partners of which varied. Trisomy of chromosome 21 occurred more often in ciliary body melanomas, whilst rearrangements of chromosomes 6 and 11 were primarily related to choroidal melanomas. Our results imply that alterations of chromosome 1 are important in the progression of some uveal melanomas, and that other chromosome abnormalities, besides those of chromosomes 3 and 8, are associated with ocular tumours of particular locations. © 2000 Cancer Research Campaig

Using Polymeric Ionic Liquids as an Active Binder in Supercapacitors

Electrodes in batteries and supercapacitors generally contain inert binders to maintain their structural integrity during operation but do not participate in the storage of energy. In this paper, we demonstrate that poly ionic liquids can function as structural binders while simultaneously improving the energy storage capability of supercapacitors. Specifically, we show that when the ionic liquid N-butyl-N-methyl pyrrolidinium bis(trifluoromethanesulfonyl)imide is used as electrolyte and poly(diallyldimethylammonium) bis(trifluoromethanesulfonyl)imide is employed as electrode binder the permissible operating voltage of the device is enhanced to 4.0 V. This results in a substantially increased overall specific energy (80% greater) and represents a step toward the development of devices with long cycle lives and high energy densities

Interobserver agreement for neonatal seizure detection using multichannel EEG

Objective To determine the interobserver agreement (IOA) of neonatal seizure detection using the gold standard of conventional, multichannel EEG. Methods A cohort of full-term neonates at risk of acute encephalopathy was included in this prospective study. The EEG recordings of these neonates were independently reviewed for seizures by three international experts. The IOA was estimated using statistical measures including Fleiss' kappa and percentage agreement assessed over seizure events (event basis) and seizure duration (temporal basis). Results A total of 4066 h of EEG recordings from 70 neonates were reviewed with an average of 2555 seizures detected. The IOA was high with temporal assessment resulting in a kappa of 0.827 (95% CI: 0.769–0.865; n = 70). The median agreement was 83.0% (interquartile range [IQR]: 76.6–89.5%; n = 33) for seizure and 99.7% (IQR: 98.9–99.8%; n = 70) for nonseizure EEG. Analysis of events showed a median agreement of 83.0% (IQR: 72.9–86.6%; n = 33) for seizures with 0.018 disagreements per hour (IQR: 0.000–0.090 per hour; n = 70). Observers were more likely to disagree when a seizure was less than 30 sec. Overall, 33 neonates were diagnosed with seizures and 28 neonates were not, by all three observers. Of the remaining nine neonates with contradictory EEG detections, seven presented with low total seizure burden. Interpretation The IOA is high among experts for the detection of neonatal seizures using conventional, multichannel EEG. Agreement is reduced when seizures are rare or have short duration. These findings support EEG-based decision making in the neonatal intensive care unit, inform EEG interpretation guidelines, and provide benchmarks for seizure detection algorithms.Peer reviewe

Gallium interactions with zircaloy cladding

The effects of Ga from weapons-grade plutonium MOX fuel on zircaloy-IV cladding during power reactor operation have been simulated by implantations of 100 keV Ga-69 ions into a polished zircaloy-IV sample while the sample was maintained at a typical cladding temperature of 375{degrees}C. Analyses were based on scanning electron microscopy, Rutherford backscattering of 280 keV He-3 ions, and secondary ion mass spectroscopy. Subgrains at the zircaloy-IV surface formed at a Ga fluence equivalent to total release of approximately 12 ppm by weight of Ga from the fuel. The subgrains may be an intermetallic compound of Zr{sub 2}Ga. Enhanced diffusion of Ga was observed, but Ga concentrations decreased 3 orders of magnitude over a depth of 3000 {angstrom}

Design Actuator Control Unit for Aerospace Applications: Automatic Closed-Loop Control for Permanent Magnet Brushless DC Motors

Actuators are the building block for every automated system. The field of applications is wide open, from home appliances to aerospace. In this joint project between OTM Servo Mechanism and Brunel University London, we design and develop custom-tailored actuators for the aerospace industry. Actuators at aerospace specifications are suitable for many applications, such as aeroplanes and unmanned aerial vehicles (UAV). The design requires significant considerations of the hosting working environment and size and weight constraints. This paper discusses the design, model and simulation of an actuator control unit (ACU) for an electromechanical actuator driven by a 51mm airborne three-phase brushless DC motor. By modelling and simulating the whole system, we can set and tune the control modes of the controller. The ACU comprises the controller and necessary components to complete the automatic control process. We rely on a set of feedback control loops to meet the desired setpoints for the employed actuator despite the applied load and disturbances. Electromechanical actuators are an excellent fit for all-electric systems that require new developments in the field of automatically controlled actuators.10.13039/100014013-UK Research and Innovatio