A meta-analysis of transdiagnostic cognitive behavioural therapy in the treatment of child and young person anxiety disorders

Background: Previous meta-analyses of cognitive-behavioural therapy (CBT) for children and young people with anxiety disorders have not considered the efficacy of transdiagnostic CBT for the remission of childhood anxiety. Aim: To provide a meta-analysis on the efficacy of transdiagnostic CBT for children and young people with anxiety disorders. Methods: The analysis included randomized controlled trials using transdiagnostic CBT for children and young people formally diagnosed with an anxiety disorder. An electronic search was conducted using the following databases: ASSIA, Cochrane Controlled Trials Register, Current Controlled Trials, Medline, PsycArticles, PsychInfo, and Web of Knowledge. The search terms included “anxiety disorder(s)”, “anxi∗”, “cognitive behavio∗, “CBT”, “child∗”, “children”, “paediatric”, “adolescent(s)”, “adolescence”, “youth” and “young pe∗”. The studies identified from this search were screened against the inclusion and exclusion criteria, and 20 studies were identified as appropriate for inclusion in the current meta-analysis. Pre- and posttreatment (or control period) data were used for analysis. Results: Findings indicated significantly greater odds of anxiety remission from pre- to posttreatment for those engaged in the transdiagnostic CBT intervention compared with those in the control group, with children in the treatment condition 9.15 times more likely to recover from their anxiety diagnosis than children in the control group. Risk of bias was not correlated with study effect sizes. Conclusions: Transdiagnostic CBT seems effective in reducing symptoms of anxiety in children and young people. Further research is required to investigate the efficacy of CBT for children under the age of 6

A critical perspective on learning outcomes and the effectiveness of experiential approaches in entrepreneurship education: do we innovate or implement?

Purpose – The purpose of this paper is to conduct a critical appraisal of how experiential approaches can more effectively enhance the achievement of desired learning outcomes in entrepreneurship education. In particular, the authors critique whether actual learning outcomes can be profitably used to measure effectiveness; and consider how student performance can be evaluated through the twin lenses of implementation or innovation. Design/methodology/approach – The authors undertook a review of both traditional and experiential approaches to entrepreneurship education. In addition to comparing these approaches, the authors critiqued a number of “taken for granted” assumptions regarding the effectiveness of experiential approaches to entrepreneurship education and made recommendations. Findings – Although there is a large body of research on experiential approaches towards entrepreneurship education, the authors know little about how these approaches contribute towards the effective achievement of desired learning outcomes. Whilst many authors claim that such approaches are effective, such assertions are not supported by sufficient robust evidence. Hence the authors need to establish more effective student performance evaluation metrics. In particular: first, whether actual learning outcomes are appropriate measures of effectiveness; and second, the authors should evaluate student performance through the lenses of the two “Is” – implementation or innovation. Practical implications – Whether actual learning outcomes are used as a measure of effectiveness at all needs to be critiqued further. Implementation involves doing things that are determined by others and matching against their expectations, whereas innovation comprises producing multiple and varied solutions that respond to change and often surprise. Originality/value – Through revisiting the discussions on the art and the science of entrepreneurship education, this paper represents an initial critical attempt – as part of an ongoing study – to fill a gap in entrepreneurship education research. The paper, therefore, has significant value for students, entrepreneurship educators and policy-makers

Constructive Misalignment? Learning outcomes and effectiveness in teamwork-based experiential entrepreneurship education assessment

Objectives: Despite extensive research on experiential entrepreneurship education (EEE), we know little about how these approaches contribute towards effective achievement of learning outcomes (LOs), particularly in terms of opportunity discovery and exploitation. We critically appraised how experiential approaches enhance the achievement of learning outcomes (LOs) in teamwork-based entrepreneurship education assessment. Prior Work: Extant EEE research tends to focus upon “good practice”, rather than establishing its impact upon students. The argument for experiential approaches is two-fold but with a missing third fold (Scott et al, 2016): (1) ‘Traditional’ programmes, which rely upon lectures or other directed, non-experiential approaches to entrepreneurship education, are not effectively achieving their objectives, or these objectives are not ambitious enough to achieve effective outcomes; (2) Experiential approaches are an interactive, participative, realistic, viable and potentially more effective alternative to these ‘traditional’ approaches and include, for example, simulation etc; and (3) There is a lack of evidence on their effectiveness, though with some relatively recent exceptions, alongside a continuing debate about whether entrepreneurship can even be taught. Approach: We adopted an exploratory qualitative analysis of reflective diaries to achieve our objectives. Data were gathered from a purposive and convenience sample of reflective diaries, an individual assessment element of three Masters-level modules (modules 1, 2 and 3), in which there are also group business ideas generation presentations and a report. We subjected the text to rigorous content analysis (Silverman, 2004, 2010; Eriksson and Kovalainen, 2008; Curtis and Curtis, 2011), which often adds a positivistic epistemological flavour to qualitative research, and our text was partially quantified to enable in-depth qualitative analysis. Results: Our analysis of student reflective diaries revealed that, while a number of LOs were met in relation to teamwork and communication, those related to innovation (i.e. generating a business idea) were much more modest. Yet, students experienced negative aspects which have become learning opportunities, such as linguistic-cultural challenges and overcoming nonparticipation/freeriding. Although Biggs (2003) has argued the need for constructive alignment in course design, in fact some of these unexpected LOs suggest the possibility that constructive misalignment could, in certain circumstances (e.g. experiential entrepreneurship education), be a positive pedagogical outcome. Implications and Value: There is, however, still little evidence that EEE is more effective than other approaches that have traditionally been adopted

LMG 14-11: Cruise Report - ChinStrAP: Changes in Stratification at the Antarctic Peninsula

The goal of the ChinStrAP (Changes in Stratification at the Antarctic Peninsula) project is to assess the role of mesoscale and submesoscale variability on water mass transformation and exchange across the continental shelf and slope in southern Drake Passage. Specifically we plan to: 1. Assess the influence of flow-topography interactions on the frequency and characteristics of mesoscale eddy generation along the southern boundary of the ACC. We will be sampling a region where the strong southern ACC front (SACCF) and the ACC’s southern boundary run along the continental slope before interacting with the Shackleton Fracture Zone (SFZ) and deflecting northward. This is a known region of eddy generation, as observed from remotely-sensed sea surface height (SSH), sea surface temperature (SST) and ocean color observations. We hope to obtain the in situ observations necessary to determine the mechanisms by which these eddies are formed and how they contribute to cross-shelf exchange. 2. Explore the interactions between surface wind and buoyancy forcing on mixed layer depth variability and its implications for ventilation of the deep ocean. Southern Drake Passage is a key location where deep isopycnals rise towards the surface across the ACC and outcrop allowing direct exchange with atmospheric temperatures and gases. This process is critical to the equilibration of dissolved gas concentrations with atmospheric values and thus influences large-scale characteristics of Earth’s climate. A large number of recent studies have pointed to the strong influence of submesoscale processes, both due to surface forcing and stirring by mesoscale eddies, on rapid changes in mixed layer depth. These changes come about through dynamic instabilities related to lateral gradients in mixed layer properties. The ACC is a location where strong lateral fronts align with strong westerly winds. This situation is similar to western boundary currents, however the internal density structure is considerably different in the ACC. Our measurement strategy should allow us to capture the evolution of these dynamical processes. 3. Carry out an XBT/XCTD transect across Drake Passage on the southbound leg as a contribution to Scripps High Resolution XBT/XCTD observing line (WOCE AX22). This information will provide larger-scale context for the data collected from the three gliders. 4. Determine with high spatially- and temporally-resolved measurements the characteristic internal variability in this regional current system. This work will help to better interpret long-term observations in this same location (e.g., LTER monitoring, the AX22 high resolution XBT/XCTD line). The observations will also help validate high frequency variability in numerical models as they push towards resolving key dynamical processes at the continental shelf break

Finite Element Analysis of Moso Bamboo-Reinforced Southern Pine Osb Composite Beams

A finite element (FE) analysis was performed to investigate the flexural properties of a structural composite lumber—Moso bamboo (Phyllostachys pubescens) reinforced southern pine oriented strand-board (OSB). Parametric analyses were conducted to investigate the stress and displacement distributions. Various beam configurations as affected by glue, web structure, flange composition, and bamboo-OSB combination were considered. The comparison of the numerical results from the selected models with those from bending tests was also performed. Finally, a rational design criterion for this type of composite beam was proposed based on the analytical and experimental studies. Bamboo is capable of improving the flexural properties of the OSB for use as a structural beam or joist. At a given cross section of about 30 X 140 mm, for instance, two-layer (6.4-mm thickness each) laminated bamboo flange can increase the OSB beam's maximum bending stress by 60 to 70% and double its stiffness. The total flange thickness, rather than the thickness of each layer, controls the beam deflection while the flange with a thinner layer (3.2 mm) resulted in higher bending, vertical, and transverse stresses but lower in-plane shear stress. More reinforcing material in the composite beam could reduce the maximum bending stress but would likely increase beam weight and processing cost. From this study, it is suggested that a two-layer flanged composite beam would be favorable from a material processing standpoint as well as superior in engineering performance over other configurations of bamboo-OSB composite beam product

The value of prognostic ultrasound features of breast cancer in different molecular subtypes with a focus on triple negative disease

The ultrasound (US) features of breast cancer have recently been shown to have prognostic significance. We aim to assess these features according to molecular subtype. 1140 consecutive US visible invasive breast cancers had US size and mean stiffness by shearwave elastography (SWE) recorded prospectively. Skin thickening (> 2.5 mm) overlying the cancer on US and the presence of posterior echo enhancement were assessed retrospectively while blinded to outcomes. Cancers were classified as luminal, triple negative (TN) or HER2 + ve based on immunohistochemistry and florescent in-situ hybridization. The relationship between US parameters and breast cancer specific survival (BCSS) was ascertained using Kaplan–Meier survival curves and ROC analysis. At median follow-up 6.3 year, there were 117 breast cancer (10%) and 132 non-breast deaths (12%). US size was significantly associated with BCSS all groups (area under the curve (AUC) 0.74 in luminal cancers, 0.64 for TN and 0.65 for HER2 + ve cancers). US skin thickening was associated most strongly with poor prognosis in TN cancers (53% vs. 80% 6 year survival, p = 0.0004). Posterior echo enhancement was associated with a poor BCSS in TN cancers (63% vs. 82% 6 year survival, p = 0.02). Mean stiffness at SWE was prognostic in the luminal and HER2 positive groups (AUC 0.69 and 0.63, respectively). In the subgroup of patients with TN cancers receiving neo-adjuvant chemotherapy posterior enhancement and skin thickening were not associated with response. US skin thickening is a poor prognostic indicator is all 3 subtypes studied, while posterior enhancement was associated with poor outcome in TN cancer

Chip-Based Measurement-Device-Independent Quantum Key Distribution

Modern communication strives towards provably secure systems which can be widely deployed. Quantum key distribution provides a methodology to verify the integrity and security of a key exchange based on physical laws. However, physical systems often fall short of theoretical models, meaning they can be compromised through uncharacterized side-channels. The complexity of detection means that the measurement system is a vulnerable target for an adversary. Here, we present secure key exchange up to 200 km while removing all side-channels from the measurement system. We use mass-manufacturable, monolithically integrated transmitters that represent an accessible, quantum-ready communication platform. This work demonstrates a network topology that allows secure equipment sharing which is accessible with a cost-effective transmitter, significantly reducing the barrier for widespread uptake of quantum-secured communication

An integrated cryogenic optical modulator

Integrated electrical and photonic circuits (PIC) operating at cryogenic temperatures are fundamental building blocks required to achieve scalable quantum computing, and cryogenic computing technologies. Optical interconnects offer better performance and thermal insulation than electrical wires and are imperative for true quantum communication. Silicon PICs have matured for room temperature applications but their cryogenic performance is limited by the absence of efficient low temperature electro-optic (EO) modulation. While detectors and lasers perform better at low temperature, cryogenic optical switching remains an unsolved challenge. Here we demonstrate EO switching and modulation from room temperature down to 4 K by using the Pockels effect in integrated barium titanate (BaTiO3)-based devices. We report the nonlinear optical (NLO) properties of BaTiO3 in a temperature range which has previously not been explored, showing an effective Pockels coefficient of 200 pm/V at 4 K. We demonstrate the largest EO bandwidth (30 GHz) of any cryogenic switch to date, ultra-low-power tuning which is 10^9 times more efficient than thermal tuning, and high-speed data modulation at 20 Gbps. Our results demonstrate a missing component for cryogenic PICs. It removes major roadblocks for the realisation of novel cryogenic-compatible systems in the field of quantum computing and supercomputing, and for interfacing those systems with the real world at room-temperature

A mixed-methods evaluation of patients’ views on primary care multi-disciplinary teams in Scotland

BackgroundExpanding primary care multi-disciplinary teams (MDTs) was a key component of the 2018 Scottish GP contract, with over 4,700 MDT staff appointed since then.AimTo explore patients’ views on primary care MDT expansion in Scotland.Design and methods(1) Survey of patients recently consulting a GP in deprived-urban, affluent-urban and remote/rural areas, assessing awareness of five MDT roles and attitudes towards receptionist signposting; (2) 30 individual interviews exploring MDT-care experiences.ResultsOf 1,053 survey respondents, most were unaware of the option of MDT rather than GP consultations for three out of five roles (69% unaware of link worker appointments; 68% mental health nurse; 58% pharmacist). Reception signposting was less popular in deprived-urban areas (34% unhappy vs 29% in remote/rural vs 21% affluent-urban; p&lt;0.001), and in patients with multimorbidity (31% unhappy vs 24% in non-multimorbid; p&lt;0.05).Two-thirds of interviewees had multimorbidity and almost all reported positive MDT-care experiences. However, MDT-care was generally seen as a supplement rather than a substitute for GP care. Around half of patients expressed concerns about reception signposting. These patients were more likely to also express concerns about GP access in general. Both of these concerns were more common in deprived-urban areas than in remote/rural or affluent-urban areas.ConclusionMDT-care has expanded in Scotland with limited patient awareness. Although patients understand its potential value, many are unhappy with reception signposting to first-contact MDT care, especially those in deprived-urban areas living with multimorbidity. This represents a barrier to the aims of the new GP contract.<br/