The CIPRUS study, a nurse-led psychological treatment for patients with undifferentiated somatoform disorder in primary care: study protocol for a randomised controlled trial

Background: Up to a third of patients presenting medically unexplained physical symptoms in primary care may have a somatoform disorder, of which undifferentiated somatoform disorder (USD) is the most common type. Psychological interventions can reduce symptoms associated with USD and improve functioning. Previous research has either been conducted in secondary care or interventions have been provided by general practitioners (GPs) or psychologists in primary care. As efficiency and cost-effectiveness are imperative in primary care, it is important to investigate whether nurse-led interventions are effective as well. The aim of this study is to examine the effectiveness and cost-effectiveness of a short cognitive behavioural therapy (CBT)-based treatment for patients with USD provided by mental health nurse practitioners (MHNPs), compared to usual care. Methods: In a cluster randomised controlled trial, 212 adult patients with USD will be assigned to the intervention or care as usual. The intervention group will be offered a short, individual CBT-based treatment by the MHNP in addition to usual GP care. The main goal of the intervention is that patients become less impaired by their physical symptoms and cope with symptoms in a more effective way. In six sessions patients will receive problem-solving treatment. The primary outcome is improvement in physical functioning, measured by the physical component summary score of the RAND-36. Secondary outcomes include health-related quality of life measured by the separate subscales of the RAND-36, somatization (PHQ-15) and symptoms of depression and anxiety (HADS). Problem-solving skills, health anxiety, illness perceptions, coping, mastery and working alliance will be assessed as potential mediators. Assessments will be done at 0, 2, 4, 8 and 12 months. An economic evaluation will be conducted from a societal perspective with quality of life as the primary outcome measure assessed by the EQ-5D-5L. Health care, patient and lost productivity costs will be assessed with the Tic-P. Discussion: We expect that the intervention will improve physical functioning and is cost-effective compared to usual care. If so, more patients might successfully be treated in general practice, decreasing the number of referrals to specialist care. Trial registration: Dutch Trial Registry, identifier: NTR4686, Registered on 14 July 2014. © 2017 The Author(s)

Prediction and measurement of the size-dependent stability of fluorescence in diamond over the entire nanoscale

Fluorescent defects in non-cytotoxic diamond nanoparticles are candidates for qubits in quantum computing, optical labels in biomedical imaging and sensors in magnetometry. For each application these defects need to be optically and thermodynamically stable, and included in individual particles at suitable concentrations (singly or in large numbers). In this letter, we combine simulations, theory and experiment to provide the first comprehensive and generic prediction of the size, temperature and nitrogen-concentration dependent stability of optically active NV defects in nanodiamonds.Comment: Published in Nano Letters August 2009 24 pages, 6 figure

Gender differences in conversation topics, 1922–1990

Gender differences in conversation topics were first systematically studied in 1922 by Henry Moore, who theorized that the gender differences in topic choice he observed in a field observation study would persist over time, as they were manifestations of men's and women's “original natures.” In this paper, I report a 1990 replication of Moore's study, in which similar but smaller gender differences in topic choice are found. In order to explore further the apparent trend toward smaller gender differences, reports of quantitative observation studies conducted between 1922 and 1990 are examined. Other explanations besides change over time—such as variations in conversation setting and audience, target populations, and researcher's intentions—may account for the decline in gender differences in topic choice. Social influences are seen more clearly in the discourse about gender differences in conversation than in gender differences in conversation topics themselves.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45599/1/11199_2004_Article_BF00289744.pd

In situ analysis of PCBN cutting tool materials during thermo-mechanical loading using synchrotron radiation

Polycrystalline cubic boron nitride (PCBN) has outstanding properties in terms of hardness and chemical stability at elevated temperatures. Therefore, PCBN is used in cutting tool materials for hard machining applications e.g. hard turning of hardened steels. Due to the hardness of the workpiece, high forces act on a low contact area between tool and workpiece. Hence, severe thermo-mechanical loadings occur in such applications causing enhanced tool wear. Fundamental knowledge about the material behavior of PCBN-cutting-materials under thermo-mechanical loading is valuable as a basis for a better understanding of tool wear and finally for improvement of tool wear behavior. PCBN-materials are polycrystalline multi-phase compounds with strongly deviating material properties. In order to investigate the phase selective thermo-mechanical behavior of such materials lattice strain measurements are conducted under thermo-mechanical load using in situ X-ray diffraction with high energy synchrotron radiation. A four point bending test set-up and ceramic thermal heaters are used for the application of thermo-mechanical loading. Three different materials are investigated: a solid low PCBN-content material, a low PCBN-content material on a cemented carbide (CC) substrate and a high PCBN-content material on a CC-substrate. The low PCBN-content material exhibits a single phase binder material whereas the high PCBN-content material exhibits a multi-phase binder with up to five phases. Residual stresses are found in the samples with CC-substrate, only. Different phases of one material show different strains but nearly same stresses upon loading. Thus, thermo-mechanical loading can be seen as superposition of the respective mechanical and thermal loads. The space-resolved experimental data is used to validate an analytical model for the calculation of macroscopic stresses. The phase selective space-resolved strain and stress analysis presented in this paper provides a valuable method for the investigation and optimization of hard cutting tool materials and coatings under real cutting conditions

In situ Sichtbarmachung von Schwebstoffpartikeln mittels Unterwasservideomikroskop zur morphologischen Partikelbeschreibung Abschlussbericht

The underwater videomicroskop represents an optical measuring concept for visualization and characterization of suspended matter in rivers, lakes and seas. An image of the measuring volume, which spreads 0,9 x 1,2 mm, is formed by a CCD camera which is equipped with macro lenses. The image contains 512 x 512 picture elements each 2,38 x 1,79 #mu#m with a resolution of 256 grey levels. A Xenon Flash with a puls duration of 2 #mu#s and a frequency of 25-100 allows the freezing of particles with a relative velocity of up to 50 cm/s without movement blur and the determination of its relative velocity. The images may be examined visually on the monitor, stored on video tape and analyzed online by digital image analysis. The analysis may be performed offline for variation of test parameters. For the interpretation of the image an interactive or automated analysis software has been designed. The characteristic parameters are diameter of circle of same area, axis ratio of approximating ellipse and several form describing parameters (fourier coefficients, tangent angles, ratio perimeter/area). By means of the form parameters effects of a non spherical particles form may be quantified (i.e. measuring error, dynamic behavior, chemical properties). The application of these measuring technique are amongst others suspended matter transport, material characterization, water quality management and limnology. (orig.)SIGLEAvailable from TIB Hannover: F97B635+a / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekBundesministerium fuer Bildung, Wissenschaft, Forschung und Technologie, Bonn (Germany)DEGerman