Using Cognitive Behavioral Therapy to treat anxiety in a school-based setting

Anxiety disorders are the most common disorder found among all school-aged children. Adults working in the education field need to be made aware of symptoms and treatments for their students when they’re having these heightened feelings of anxiety. According to Hirshfeld-Becker et al. (2010), research has shown that cognitive behavioral therapy is the most commonly implemented and effective source of therapy. It has also been shown to be the most clinically effective way to intervene and decrease anxiety disorders among children as young as four (Hirshfeld-Becker et al., 2010). This literature review examines the prevalence of anxiety among school-aged children and the most effective way to treat anxiety disorders within a school-based setting. In doing so, we are investigating the effectiveness of cognitive behavioral therapy intervention and prevention programs and their effectiveness in schools to treat elevated levels of anxiety disorders among school-aged students. Another aspect of research conducted by Haugland et al. (2017), shows certain barriers seen when implementing cognitive behavioral therapy in schools and the importance of multicultural considerations. With all the information considered, this literature review also develops a group manual, which will be used with Elementary and early Middle school-aged students (8-12 years old) experiencing anxiety. The group manual is called “My Worries Workshop” and it is an 8-week school-based Cognitive Behavioral Therapy (CBT) program designed to help students overcome their anxiety. Through a multitude of group discussions, activities, and homework, this group manual will help these students process their anxiety and change the way they think about it through a process called cognitive restructuring

Molecules in the Circumstellar Disk Orbiting BP Piscium

BP Psc is a puzzling late-type, emission-line field star with large infrared excess. The star is encircled and enshrouded by a nearly edge-on, dust circumstellar disk, and displays an extensive jet system similar to those associated with pre-main sequence (pre-MS) stars. We conducted a mm-wave molecular line survey of BP Psc with the 30 m telescope of the Institut de Radio Astronomie Millimetrique (IRAM). We detected lines of 12CO and 13CO and, possibly, very weak emission from HCO+ and CN; HCN, H2CO, and SiO are not detected. The CO line profiles of BP Psc are well fit by a model invoking a disk in Keplerian rotation. The mimumum disk gas mass, inferred from the 12CO line intensity and 13CO/12CO line ratio, is ~0.1 Jupiter masses. The weakness of HCO+ and CN (relative to 13CO) stands in sharp contrast to the strong HCO+ and CN emission that characterizes most low-mass, pre-main sequence stars that have been the subjects of molecular emission-line surveys, and is suggestive of a very low level of X-ray-induced molecular ionization within the BP Psc disk. These results lend some support to the notion that BP Psc is an evolved star whose circumstellar disk has its origins in a catastrophic interaction with a close companion.Comment: 6 pages, 4 figures; to appear in Astronomy & Astrophysic

Nitrogen chemistry and depletion in starless cores

We investigated the chemistry of nitrogen--containing species, principally isotopomers of CN, HCN, and HNC, in a sample of pre-protostellar cores. We used the IRAM 30 m telescope to measure the emission in rotational and hyperfine transitions of CN, HCN, 13CN, H13CN, HN13C, and HC15N, in L 1544, L 183, Oph D, L 1517B, L 310. The observations were made along axial cuts through the dust emission peak, at a number of regularly--spaced offset positions. The observations were reduced and analyzed to obtain the column densities, using the measurements of the less abundant isotopic variants in order to minimize the consequences of finite optical depths in the lines. The observations were compared with the predictions of a free--fall gravitational collapse model, which incorporates a non-equilibrium treatment of the relevant chemistry. We found that CN, HCN, and HNC remain present in the gas phase at densities well above that at which CO depletes on to grains. The CN:HCN and the HNC:HCN abundance ratios are larger than unity in all the objects of our sample. Furthermore, there is no observational evidence for large variations of these ratios with increasing offset from the dust emission peak and hence with density. Whilst the differential freeze--out of CN and CO can be understood in terms of the current chemistry, the behaviour of the CN:HCN ratio is more difficult to explain. Models suggest that most nitrogen is not in the gas phase but may be locked in ices. Unambiguous conclusions require measurements of the rate coefficients of the key neutral--neutral reactions at low temperatures

Sub-cortical and brainstem sites associated with chemo-stimulated increases in ventilation in humans

We investigated the neural basis for spontaneous chemo-stimulated increases in ventilation in awake, healthy humans. Blood oxygen level dependent (BOLD) functional MRI was performed in nine healthy subjects using T2weighted echo planar imaging. Brain volumes (52 transverse slices, cortex to high spinal cord) were acquired every 3.9 s. The 30 min paradigm consisted of six, 5-min cycles, each cycle comprising 45 s of hypoxic-isocapnia, 45 s of isooxic-hypercapnia and 45 s of hypoxic-hypercapnia, with 55 s of non-stimulatory hyperoxic-isocapnia (control) separating each stimulus period. Ventilation was significantly (p < 0.001) increased during hypoxic-isocapnia, isooxic-hypercapnia and hypoxic-hypercapnia (17.0, 13.8, 24.9 L/min respectively) vs. control (8.4 L/min) and was associated with significant (p < 0.05, corrected for multiple comparisons) signal increases within a bilateral network that included the basal ganglia, thalamus, red nucleus, cerebellum, parietal cortex, cingulate and superior mid pons. The neuroanatomical structures identified provide evidence for the spontaneous control of breathing to be mediated by higher brain centres, as well as respiratory nuclei in the brainstem

Medroxyprogesterone improves nocturnal breathing in postmenopausal women with chronic obstructive pulmonary disease

BACKGROUND: Progestins as respiratory stimulants in chronic obstructive pulmonary disease (COPD) have been investigated in males and during wakefulness. However, sleep and gender may influence therapeutic responses. We investigated the effects of a 2-week medroxyprogesterone acetate (MPA) therapy on sleep and nocturnal breathing in postmenopausal women. METHODS: A single-blind placebo-controlled trial was performed in 15 postmenopausal women with moderate to severe COPD. A 12-week trial included 2-week treatment periods with placebo and MPA (60 mg/d/14 days). All patients underwent a polysomnography with monitoring of SaO(2 )and transcutaneous PCO(2 )(tcCO(2)) at baseline, with placebo, with medroxyprogesterone acetate (MPA 60 mg/d/14 days), and three and six weeks after cessation of MPA. RESULTS: Thirteen patients completed the trial. At baseline, the average ± SD of SaO(2 )mean was 90.6 ± 3.2 % and the median of SaO(2 )nadir 84.8 % (interquartile range, IQR 6.1). MPA improved them by 1.7 ± 1.6 %-units (95 % confidence interval (CI) 0.56, 2.8) and by 3.9 %-units (IQR 4.9; 95% CI 0.24, 10.2), respectively. The average of tcCO(2 )median was 6.0 ± 0.9 kPa and decreased with MPA by 0.9 ± 0.5 kPa (95% CI -1.3, -0.54). MPA improved SaO(2 )nadir and tcCO(2 )median also during REM sleep. Three weeks after cessation of MPA, the SaO(2 )mean remained 1.4 ± 1.8 %-units higher than at baseline, the difference being not significant (95% CI -0.03, 2.8). SaO(2 )nadir was 2.7 %-units (IQR 4.9; 95% CI 0.06, 18.7) higher than at baseline. Increases in SaO(2 )mean and SaO(2 )nadir during sleep with MPA were inversely associated with baseline SaO(2 )mean (r = -0.70, p = 0.032) and baseline SaO(2 )nadir (r = -0.77, p = 0.008), respectively. Treatment response in SaO(2 )mean, SaO(2 )nadir and tcCO(2 )levels did not associate with pack-years smoked, age, BMI, spirometric results or sleep variables. CONCLUSION: MPA-induced respiratory improvement in postmenopausal women seems to be consistent and prolonged. The improvement was greater in patients with lower baseline SaO(2 )values. Long-term studies in females are warranted

Dense gas in nearby galaxies XVI. The nuclear starburst environment in NGC4945

A multi-line millimeter-wave study of the nearby starburst galaxy NGC 4945 has been carried out using the Swedish-ESO Submillimeter Telescope (SEST). The study covers the frequency range from 82 GHz to 354 GHz and includes 80 transitions of 19 molecules. 1.3 mm continuum data of the nuclear source are also presented. A large number of molecular species indicate the presence of a prominent high density interstellar gas component characterized by $n_{\rm H_2}\sim10^5$ cm$^{-3}$. Abundances of molecular species are calculated and compared with abundances observed toward the starburst galaxies NGC 253 and M 82 and galactic sources. Apparent is an `overabundance' of HNC in the nuclear environment of NGC 4945. While the HNC/HCN $J$=1--0 line intensity ratio is $\sim$0.5, the HNC/HCN abundance ratio is $\sim$1. While HCN is subthermally excited ($T_{\rm ex}\sim$8 K), CN is even less excited ($T_{\rm ex}\sim$3--4 K), indicating that it arises from a less dense gas component and that its $N$=2--1 line can be optically thin even though its $N$=1--0 emission is moderately optically thick. Overall, fractional abundances of NGC 4945 suggest that the starburst has reached a stage of evolution that is intermediate between those observed in NGC 253 and M 82. Carbon, nitrogen, oxygen and sulfur isotope ratios are also determined. Within the limits of uncertainty, carbon and oxygen isotope ratios appear to be the same in the nuclear regions of NGC 4945 and NGC 253. High $^{18}$O/$^{17}$O, low $^{16}$O/$^{18}$O and $^{14}$N/$^{15}$N and perhaps also low $^{32}$S/$^{34}$S ratios appear to be characteristic properties of a starburst environment in which massive stars have had sufficient time to affect the isotopic composition of the surrounding interstellar medium.Comment: 26 pages, 16 figures, accepted bt A&

Molecules in the disk orbiting the twin young suns of V4046 Sgr

We report the results of a mm-wave molecular line survey of the nearby (D ~ 70 pc), 12 Myr-old system V4046 Sgr -- a tight (9 R_sun separation), short-period (2.42 day) binary with nearly equal component masses of ~0.9 M_sun -- conducted with the 30 m telescope of the Institut de Radio Astronomie Millimetrique (IRAM). We detected rotational transitions of 12CO 13CO, HCN, CN, and HCO+. The double-peaked CO line profiles of V4046 Sgr are well fit by a model invoking a Keplerian disk with outer radius of ~250 AU that is viewed at an inclination i = 35 degrees. We infer minimum disk gas and dust masses of ~13 and ~20 Earth masses from the V4046 Sgr CO line and submm continuum fluxes, respectively. The actual disk gas mass could be much larger if the gas-phase CO is highly depleted and/or 13CO is very optically thick. The overall similarity of the circumbinary disk of V4046 Sgr to the disk orbiting the single, ~8 Myr-old star TW Hya -- a star/disk system often regarded as representative of the early solar nebula -- indicates that gas giant planets are likely commonplace among close binary star systems. Given the relatively advanced age and proximity of V4046 Sgr, these results provide strong motivation for future high-resolution imaging designed to ascertain whether a planetary system now orbits its twin suns.Comment: 5 pages, 3 figures; to appear in Astronomy & Astrophysic

Application of the Occupational Sitting and Physical Activity Questionnaire (OSPAQ) to office based workers

Background The workplace is a setting where sedentary behaviour is highly prevalent. Accurately measuring physical activity and sedentary behaviour is crucial to assess the impact of behavioural change interventions. This study aimed to evaluate the reliability and criterion validity of the Occupational Sitting and Physical Activity Questionnaire (OSPAQ) and compare with data collected by accelerometers. Methods A test-retest study was undertaken on 99 participants using the OSPAQ. Data were then compared to accelerometer records of 41 participants. Reliability was assessed by paired t-test and intra-class correlations (ICC) via a two-way mixed model based on absolute agreement. Difference and agreement were measured by comparison of mean self-reported data with accelerometer data using the Pearson’s correlation coefficient and Bland-Altman plots. Results The ICCs for minutes spent sitting (0.66), standing (0.83) and walking (0.77) showed moderate to strong test-retest reliability. No significant differences were found between the repeated measurements taken seven days apart. Correlations with the accelerometer readings were moderate. The Bland-Altman plots showed moderate agreement for standing time and walking time but systematic variation for sedentary time. Conclusion The OSPAQ appears to have acceptable reliability and validity measurement properties for application in the office workplace setting

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.