A Systematic Review of Music Therapy Practice and Outcomes with Acute Adult Psychiatric In-Patients

PMCID: PMC3732280This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Restoring identity: The use of religion as a mechanism to transition between an identity of sexual offending to a non-offending identity

This study examines the unique experience of participants who during their reintegration back into the community, following a conviction for sexual offending, re-engaged with religious and spiritual communities. To explore meaning Interpretative Phenomenological Analysis (IPA) was adopted. Four in-depth interviews of men convicted for sexual crimes were undertaken and analysed. Findings indicate that through religious affiliation participants were: exposed to new prosocial networks; provided opportunities to seek forgiveness; felt a sense of belonging and affiliation; and were psychologically comforted. However, the study also found that the process of identity transition from ‘offender’ to ‘non-offender’ was not seamless or straightforward for those with an innate sexual deviancy towards children, caution is therefore advised

The domestic and gendered context for retirement

Against a global backdrop of population and workforce ageing, successive UK governments have encouraged people to work longer and delay retirement. Debates focus mainly on factors affecting individuals’ decisions on when and how to retire. We argue that a fuller understanding of retirement can be achieved by recognizing the ways in which individuals’ expectations and behaviours reflect a complicated, dynamic set of interactions between domestic environments and gender roles, often established over a long time period, and more temporally proximate factors. Using a qualitative data set, we explore how the timing, nature and meaning of retirement and retirement planning are played out in specific domestic contexts. We conclude that future research and policies surrounding retirement need to: focus on the household, not the individual; consider retirement as an often messy and disrupted process and not a discrete event; and understand that retirement may mean very different things for women and for men

Beautiful Mirrors at the LHC

We explore the "Beautiful Mirrors" model, which aims to explain the measured value of $A^b_{FB}$, discrepant at the $2.9\sigma$ level. This scenario introduces vector-like quarks which mix with the bottom, subtly affecting its coupling to the $Z$. The spectrum of the new particles consists of two bottom-like quarks and a charge -4/3 quark, all of which have electroweak interactions with the third generation. We explore the phenomenology and discovery reach for these new particles at the LHC, exploring single mirror quark production modes whose rates are proportional to the same mixing parameters which resolve the $A_{FB}^b$ anomaly. We find that for mirror quark masses $\lesssim 500 GeV, a 14 TeV LHC with 300 {\rm fb}^{-1}$ is required to reasonably establish the scenario and extract the relevant mixing parameters.Comment: version to be published in JHE

Neuroimaging Evidence of Major Morpho-Anatomical and Functional Abnormalities in the BTBR T+TF/J Mouse Model of Autism

BTBR T+tf/J (BTBR) mice display prominent behavioural deficits analogous to the defining symptoms of autism, a feature that has prompted a widespread use of the model in preclinical autism research. Because neuro-behavioural traits are described with respect to reference populations, multiple investigators have examined and described the behaviour of BTBR mice against that exhibited by C57BL/6J (B6), a mouse line characterised by high sociability and low self-grooming. In an attempt to probe the translational relevance of this comparison for autism research, we used Magnetic Resonance Imaging (MRI) to map in both strain multiple morpho-anatomical and functional neuroimaging readouts that have been extensively used in patient populations. Diffusion tensor tractography confirmed previous reports of callosal agenesis and lack of hippocampal commissure in BTBR mice, and revealed a concomitant rostro-caudal reorganisation of major cortical white matter bundles. Intact inter-hemispheric tracts were found in the anterior commissure, ventro-medial thalamus, and in a strain-specific white matter formation located above the third ventricle. BTBR also exhibited decreased fronto-cortical, occipital and thalamic gray matter volume and widespread reductions in cortical thickness with respect to control B6 mice. Foci of increased gray matter volume and thickness were observed in the medial prefrontal and insular cortex. Mapping of resting-state brain activity using cerebral blood volume weighted fMRI revealed reduced cortico-thalamic function together with foci of increased activity in the hypothalamus and dorsal hippocampus of BTBR mice. Collectively, our results show pronounced functional and structural abnormalities in the brain of BTBR mice with respect to control B6 mice. The large and widespread white and gray matter abnormalities observed do not appear to be representative of the neuroanatomical alterations typically observed in autistic patients. The presence of reduced fronto-cortical metabolism is of potential translational relevance, as this feature recapitulates previously-reported clinical observations

Centre selection for clinical trials and the generalisability of results: a mixed methods study.

BACKGROUND: The rationale for centre selection in randomised controlled trials (RCTs) is often unclear but may have important implications for the generalisability of trial results. The aims of this study were to evaluate the factors which currently influence centre selection in RCTs and consider how generalisability considerations inform current and optimal practice. METHODS AND FINDINGS: Mixed methods approach consisting of a systematic review and meta-summary of centre selection criteria reported in RCT protocols funded by the UK National Institute of Health Research (NIHR) initiated between January 2005-January 2012; and an online survey on the topic of current and optimal centre selection, distributed to professionals in the 48 UK Clinical Trials Units and 10 NIHR Research Design Services. The survey design was informed by the systematic review and by two focus groups conducted with trialists at the Birmingham Centre for Clinical Trials. 129 trial protocols were included in the systematic review, with a total target sample size in excess of 317,000 participants. The meta-summary identified 53 unique centre selection criteria. 78 protocols (60%) provided at least one criterion for centre selection, but only 31 (24%) protocols explicitly acknowledged generalisability. This is consistent with the survey findings (n = 70), where less than a third of participants reported generalisability as a key driver of centre selection in current practice. This contrasts with trialists' views on optimal practice, where generalisability in terms of clinical practice, population characteristics and economic results were prime considerations for 60% (n = 42), 57% (n = 40) and 46% (n = 32) of respondents, respectively. CONCLUSIONS: Centres are rarely enrolled in RCTs with an explicit view to external validity, although trialists acknowledge that incorporating generalisability in centre selection should ideally be more prominent. There is a need to operationalize 'generalisability' and incorporate it at the design stage of RCTs so that results are readily transferable to 'real world' practice

Evaluation of Interventions in Blended Learning Using a Communication Skills Serious Game

Serious games often employ a scripted dialogue for player interaction with a virtual character. In our serious game Communicate, a domain expert develops a structured, scripted scenario as a sequence of potential interactions in an authoring tool. A player is often a student learning communication skills and a virtual character represents a person that a student talks to. In the original version of Communicate, a player `converses' with a virtual character by clicking on one of the multiple statement options. Since 2018, we perform blended learning sessions for final year computer science students using Communicate. Our goal is to improve these sessions and in this paper, we apply the action research method over three semesters to iteratively improve these blended learning sessions. In the first semester, our baseline, we conduct sessions where students play a scenario in multiple choice format. In the second semester, we enhance Communicate by enabling a student to enter open text input in an improved scenario. In the third semester, we enhance a session by incorporating peer teaching. Students fill in an evaluation survey after a session and we compare the evaluation of students from the three semesters. Results show that student ratings are significantly higher in sessions incorporating peer teaching compared to the baseline

Accuracy of breeding values of 'unrelated' individuals predicted by dense SNP genotyping

<p>Abstract</p> <p>Background</p> <p>Recent developments in SNP discovery and high throughput genotyping technology have made the use of high-density SNP markers to predict breeding values feasible. This involves estimation of the SNP effects in a training data set, and use of these estimates to evaluate the breeding values of other 'evaluation' individuals. Simulation studies have shown that these predictions of breeding values can be accurate, when training and evaluation individuals are (closely) related. However, many general applications of genomic selection require the prediction of breeding values of 'unrelated' individuals, i.e. individuals from the same population, but not particularly closely related to the training individuals.</p> <p>Methods</p> <p>Accuracy of selection was investigated by computer simulation of small populations. Using scaling arguments, the results were extended to different populations, training data sets and genome sizes, and different trait heritabilities.</p> <p>Results</p> <p>Prediction of breeding values of unrelated individuals required a substantially higher marker density and number of training records than when prediction individuals were offspring of training individuals. However, when the number of records was 2*N_e*L and the number of markers was 10*N_e*L, the breeding values of unrelated individuals could be predicted with accuracies of 0.88 – 0.93, where N_eis the effective population size and L the genome size in Morgan. Reducing this requirement to 1*N_e*L individuals, reduced prediction accuracies to 0.73–0.83.</p> <p>Conclusion</p> <p>For livestock populations, 1N_eL requires about ~30,000 training records, but this may be reduced if training and evaluation animals are related. A prediction equation is presented, that predicts accuracy when training and evaluation individuals are related. For humans, 1N_eL requires ~350,000 individuals, which means that human disease risk prediction is possible only for diseases that are determined by a limited number of genes. Otherwise, genotyping and phenotypic recording need to become very common in the future.</p

Predictive validity of the CriSTAL tool for short-term mortality in older people presenting at Emergency Departments: a prospective study

© 2018, The Author(s). Abstract: To determine the validity of the Australian clinical prediction tool Criteria for Screening and Triaging to Appropriate aLternative care (CRISTAL) based on objective clinical criteria to accurately identify risk of death within 3 months of admission among older patients. Methods: Prospective study of ≥ 65 year-olds presenting at emergency departments in five Australian (Aus) and four Danish (DK) hospitals. Logistic regression analysis was used to model factors for death prediction; Sensitivity, specificity, area under the ROC curve and calibration with bootstrapping techniques were used to describe predictive accuracy. Results: 2493 patients, with median age 78–80 years (DK–Aus). The deceased had significantly higher mean CriSTAL with Australian mean of 8.1 (95% CI 7.7–8.6 vs. 5.8 95% CI 5.6–5.9) and Danish mean 7.1 (95% CI 6.6–7.5 vs. 5.5 95% CI 5.4–5.6). The model with Fried Frailty score was optimal for the Australian cohort but prediction with the Clinical Frailty Scale (CFS) was also good (AUROC 0.825 and 0.81, respectively). Values for the Danish cohort were AUROC 0.764 with Fried and 0.794 using CFS. The most significant independent predictors of short-term death in both cohorts were advanced malignancy, frailty, male gender and advanced age. CriSTAL’s accuracy was only modest for in-hospital death prediction in either setting. Conclusions: The modified CriSTAL tool (with CFS instead of Fried’s frailty instrument) has good discriminant power to improve prognostic certainty of short-term mortality for ED physicians in both health systems. This shows promise in enhancing clinician’s confidence in initiating earlier end-of-life discussions

Behavior therapy for pediatric trichotillomania: Exploring the effects of age on treatment outcome

<p>Abstract</p> <p>Background</p> <p>A randomized controlled trial examining the efficacy of behavior therapy for pediatric trichotillomania was recently completed with 24 participants ranging in age from 7 - 17. The broad age range raised a question about whether young children, older children, and adolescents would respond similarly to intervention. In particular, it is unclear whether the younger children have the cognitive capacity to understand concepts like "urges" and whether they are able to introspect enough to be able to benefit from awareness training, which is a key aspect of behavior therapy for trichotillomania.</p> <p>Methods</p> <p>Participants were randomly assigned to receive either behavior therapy (N = 12) or minimal attention control (N = 12), which was included to control for repeated assessments and the passage of time. Primary outcome measures were the independent evaluator-rated NIMH-Trichotillomania Severity Scale, a semi-structured interview often used in trichotillomania treatment trials, and a post-treatment clinical global impression improvement rating (CGI-I).</p> <p>Results</p> <p>The correlation between age and change in symptom severity for all patients treated in the trial was small and not statistically significant. A 2 (group: behavioral therapy, minimal attention control) × 2 (time: week 0, 8) × 2 (children < 9 yrs., children > 10) ANOVA with independent evaluator-rated symptom severity scores as the continuous dependent variable also detected no main effects for age or for any interactions involving age. In light of the small sample size, the mean symptom severity scores at weeks 0 and 8 for younger and older patients randomized to behavioral therapy were also plotted. Visual inspection of these data indicated that although the groups appeared to have started at similar levels of severity for children ≤ 9 vs. children ≥ 10; the week 8 data show that the three younger children did at least as well as if not slightly better than the nine older children and adolescents.</p> <p>Conclusions</p> <p>Behavior therapy for pediatric trichotillomania appears to be efficacious even in young children. The developmental and clinical implications of these findings will be discussed.</p> <p>Trial Registration</p> <p>Clinicaltrials.gov NCT00043563.</p