A new scale to assess the therapeutic relationship in community mental health care: STAR

Background. No instrument has been developed specifically for assessing the clinician-patient therapeutic relationship (TR) in community psychiatry. This study aimed to develop a measure of the TR with clinician and patient versions using psychometric principles for test construction. Method. A four-stage prospective study was undertaken, comprising qualitative semi-structured interviews about TRs with clinicians and patients and their assessment of nine established scales for their applicability to community care, administering an amalgamated scale of more than 100 items, followed by Principal Components Analysis (PCA) of these ratings for preliminary scale construction. test-retest reliability of the scale and administering the scale in a new sample to confirm its factorial structure. The sample consisted of patients with severe mental illness and a designated key worker in the care of 17 community mental health teams in England and Sweden. Results. New items not covered by established scales were identified, including clinician helpfulness in accessing services, patient aggression and family interference. The new patient (STAR-P) and clinician scales (STAR-C) each have 12 items comprising three subscales: positive collaboration and positive clinician input in both versions, non-supportive clinician input in the patient version, and emotional difficulties in the clinician version. Test-retest reliability was r = 0(.)76 for STAR-P and r = 0(.)68 for STAR-C. The factorial structure of the new scale was confirmed with a good fit. Conclusions. STAR is a specifically developed, brief scale to assess TRs in community psychiatry with good psychometric properties and is suitable for use in research and routine care

Cross-Cohort Differences in Health on the Verge of Retirement

Baby Boomers have left a unique imprint on US culture and society in the last 60 years, and it might be anticipated that they will also put their own stamp on retirement, the last phase of the life cycle. Yet because Boomers have not all fully retired, we cannot yet judge how they will fare as retirees. Instead, we focus on how this group compares with prior groups on the verge of retirement, that is, at ages 51-56. Accordingly, this chapter evaluates the stock of health which Early Boomers bring to retirement and compare these to the circumstances of two prior cohorts at the same point in their life cycles. Using three sets of responses from the Health and Retirement Study, we find some interesting patterns. Overall, the raw evidence indicates that Boomers on the verge of retirement are in poorer health their counterparts 12 years ago. Using a summary health index designed for this study, we find that those born 1948 to 1953 share health risks with the War Baby cohort. This suggests that most of the health decline instead began before the late 1940's. A more complex set of health conclusions emerges from the specific self-reported health measures. Boomers indicate they have relatively more difficulty with a range of everyday physical tasks, but they also report having more pain, more chronic conditions, more drinking and psychiatric problems, than their HRS earlier counterparts. This trend portends poorly for the future health of Boomers as they age and incur increasing costs associated with health care and medications. Using our health index, only those at the 75th percentile or higher are likely to be characterized as having good or better health.

The non-unique Universe

The purpose of this paper is to elucidate, by means of concepts and theorems drawn from mathematical logic, the conditions under which the existence of a multiverse is a logical necessity in mathematical physics, and the implications of Godel's incompleteness theorem for theories of everything. Three conclusions are obtained in the final section: (i) the theory of the structure of our universe might be an undecidable theory, and this constitutes a potential epistemological limit for mathematical physics, but because such a theory must be complete, there is no ontological barrier to the existence of a final theory of everything; (ii) in terms of mathematical logic, there are two different types of multiverse: classes of non-isomorphic but elementarily equivalent models, and classes of model which are both non-isomorphic and elementarily inequivalent; (iii) for a hypothetical theory of everything to have only one possible model, and to thereby negate the possible existence of a multiverse, that theory must be such that it admits only a finite model

The Mass Distributions of Starless and Protostellar Cores in Gould Belt Clouds

Using data from the SCUBA Legacy Catalogue (850 um) and Spitzer Space Telescope (3.6 - 70 um), we explore dense cores in the Ophiuchus, Taurus, Perseus, Serpens, and Orion molecular clouds. We develop a new method to discriminate submillimeter cores found by SCUBA as starless or protostellar, using point source photometry from Spitzer wide field surveys. First, we identify infrared sources with red colors associated with embedded young stellar objects (YSOs). Second, we compare the positions of these YSO-candidates to our submillimeter cores. With these identifications, we construct new, self-consistent starless and protostellar core mass functions (CMFs) for the five clouds. We find best fit slopes to the high-mass end of the CMFs of -1.26 +/- 0.20, -1.22 +/- 0.06, -0.95 +/- 0.20, and -1.67 +/- 0.72 for Ophiuchus, Taurus, Perseus, and Orion, respectively. Broadly, these slopes are each consistent with the -1.35 power-law slope of the Salpeter IMF at higher masses, but suggest some differences. We examine a variety of trends between these CMF shapes and their parent cloud properties, potentially finding a correlation between the high-mass slope and core temperature. We also find a trend between core mass and effective size, but we are very limited by sensitivity. We make similar comparisons between core mass and size with visual extinction (for A_V >= 3) and find no obvious trends. We also predict the numbers and mass distributions of cores that future surveys with SCUBA-2 may detect in each of these clouds.Comment: 56 pages, 18 figures, fixed typo in Eq 1, results in paper remain unchange

Spatial and temporal patterns of land surface fluxes from remotely sensed surface temperatures within an

International audienceCharacterising the development of evapotranspiration through time is a difficult task, particularly when utilising remote sensing data, because retrieved information is often spatially dense, but temporally sparse. Techniques to expand these essentially instantaneous measures are not only limited, they are restricted by the general paucity of information describing the spatial distribution and temporal evolution of evaporative patterns. In a novel approach, temporal changes in land surface temperatures, derived from NOAA-AVHRR imagery and a generalised split-window algorithm, are used as a calibration variable in a simple land surface scheme (TOPUP) and combined within the Generalised Likelihood Uncertainty Estimation (GLUE) methodology, to provide estimates of areal evapotranspiration at the pixel scale. Such an approach offers an innovative means of transcending the patch or landscape scale of SVAT type models, to spatially distributed estimates of model output. The resulting spatial and temporal patterns of land surface fluxes and surface resistance are used to more fully understand the hydro-ecological trends observed across a study catchment in eastern Australia. The modelling approach is assessed by comparing predicted cumulative evapotranspiration values with surface fluxes determined from Bowen ratio systems and using auxiliary information such as in-situ soil moisture measurements and depth to groundwater to corroborate observed responses

Spatial and temporal patterns of land surface fluxes from remotely sensed surface temperatures within an uncertainty modelling framework

Characterising the development of evapotranspiration through time is a difficult task, particularly when utilising remote sensing data, because retrieved information is often spatially dense, but temporally sparse. Techniques to expand these essentially instantaneous measures are not only limited, they are restricted by the general paucity of information describing the spatial distribution and temporal evolution of evaporative patterns. In a novel approach, temporal changes in land surface temperatures, derived from NOAA-AVHRR imagery and a generalised split-window algorithm, are used as a calibration variable in a simple land surface scheme (TOPUP) and combined within the Generalised Likelihood Uncertainty Estimation (GLUE) methodology to provide estimates of areal evapotranspiration at the pixel scale. Such an approach offers an innovative means of transcending the patch or landscape scale of SVAT type models, to spatially distributed estimates of model output. The resulting spatial and temporal patterns of land surface fluxes and surface resistance are used to more fully understand the hydro-ecological trends observed across a study catchment in eastern Australia. The modelling approach is assessed by comparing predicted cumulative evapotranspiration values with surface fluxes determined from Bowen ratio systems and using auxiliary information such as in-situ soil moisture measurements and depth to groundwater to corroborate observed responses

NICMOS Images of the GG Tau Circumbinary Disk

We present deep, near-infrared images of the circumbinary disk surrounding the pre-main-sequence binary star, GG Tau A, obtained with NICMOS aboard the Hubble Space Telescope. The spatially resolved proto-planetary disk scatters roughly 1.5% of the stellar flux, with a near-to-far side flux ratio of ~1.4, independent of wavelength, and colors that are comparable to the central source; all of these properties are significantly different from the earlier ground-based observations. New Monte Carlo scattering simulations of the disk emphasize that the general properties of the disk, such as disk flux, near side to far side flux ratio and integrated colors, can be approximately reproduced using ISM-like dust grains, without the presence of either circumstellar disks or large dust grains, as had previously been suggested. A single parameter phase function is fitted to the observed azimuthal variation in disk flux, providing a lower limit on the median grain size of 0.23 micron. Our analysis, in comparison to previous simulations, shows that the major limitation to the study of grain growth in T Tauri disk systems through scattered light lies in the uncertain ISM dust grain properties. Finally, we use the 9 year baseline of astrometric measurements of the binary to solve the complete orbit, assuming that the binary is coplanar with the circumbinary ring. We find that the estimated 1 sigma range on disk inner edge to semi-major axis ratio, 3.2 < Rin/a < 6.7, is larger than that estimated by previous SPH simulations of binary-disk interactions.Comment: 40 pages, 8 postscript figures, accepted for publication in Ap

No Fossil Disk in the T Tauri Multiple System V773 Tau

We present new multi-epoch near-infrared and optical high-angular images of the V773 Tau pre-main sequence triple system, a weak-line T Tauri (WTTS) system in which the presence of an evolved, ``fossil'' protoplanetary disk has been inferred on the basis of a significant infrared excess. Our images reveal a fourth object bound to the system, V773 Tau D. While it is much fainter than all other components at 2 micron, it is the brightest source in the system at 4.7 micron. We also present medium-resolution K band adaptive optics spectroscopy of this object, which is featureless with the exception of a weak Br gamma emission line. Based on this spectrum and on the spectral energy distribution of the system, we show that V773 Tau D is another member of the small class of ``infrared companions'' (IRCs) to T Tauri stars. It is the least luminous, and probably the least massive, component of the system, as opposed to most other IRCs, which suggests that numerous low-luminosity IRCs such as V773 Tau D may still remain to be discovered. Furthermore, it is the source of the strong IR excess in the system. We therefore reject the interpretation of this excess as the signature of a fossil (or ``passive'') disk and further suggest that these systems may be much less frequent than previously thought. We further show that V773 Tau C is a variable classical T Tauri star (CTTS) and that its motion provides a well constrained orbital model. We show that V773 Tau D can be dynamically stable within this quadruple system if its orbit is highly inclined. Finally, V773 Tau is the first multiple system to display such a variety of evolutionary states (WTTS, CTTS, IRC), which may be the consequence of the strong star-star interactions in this compact quadruple system.Comment: Accepted for publication in Astrophysical Journal, 29 pages, 2 tables, 5 figure

Effect of NOx level on secondary organic aerosol (SOA) formation from the photooxidation of terpenes

Secondary organic aerosol (SOA) formation from the photooxidation of one monoterpene (α-pinene) and two sesquiterpenes (longifolene and aromadendrene) is investigated in the Caltech environmental chambers. The effect of NOx on SOA formation for these biogenic hydrocarbons is evaluated by performing photooxidation experiments under varying NOx conditions. The NOx dependence of α-pinene SOA formation follows the same trend as that observed previously for a number of SOA precursors, including isoprene, in which SOA yield (defined as the ratio of the mass of organic aerosol formed to the mass of parent hydrocarbon reacted) decreases as NOx level increases. The NOx dependence of SOA yield for the sesquiterpenes, longifolene and aromadendrene, however, differs from that determined for isoprene and α-pinene; the aerosol yield under high-NOx conditions substantially exceeds that under low-NOx conditions. The reversal of the NOx dependence of SOA formation for the sesquiterpenes is consistent with formation of relatively low-volatility organic nitrates, and/or the isomerization of large alkoxy radicals leading to less volatile products. Analysis of the aerosol chemical composition for longifolene confirms the presence of organic nitrates under high-NOx conditions. Consequently the formation of SOA from certain biogenic hydrocarbons such as sesquiterpenes (and possibly large anthropogenic hydrocarbons as well) may be more efficient in polluted air