Mental health service acceptability for the armed forces veteran community

This is the author accepted manuscript. The final version is available from OUP via the DOI in this record Background Despite developments in mental health services for armed forces veterans and family members, barriers to access associated with poor levels of acceptability regarding service provision remain. Adapting a Step 2 mental health service based on low-intensity cognitive behavioural therapy (CBT) interventions to represent a familiar context and meet the needs of the armed forces veteran community may serve to enhance acceptability and reduce help-seeking barriers. Aims To examine acceptability of a Step 2 low-intensity CBT mental health service adapted for armed forces veterans and family members provided by a UK Armed Forces charity. Methods Qualitative study using individual semi-structured interviews with armed forces veterans and family members of those injured or becoming unwell while serving in the British Armed Forces. Data analysis was undertaken using thematic alongside disconfirming case analysis. Results Adapting a Step 2 mental health service for armed forces veterans and family members enhanced acceptability and promoted help-seeking. Wider delivery characteristics associated with Step 2 mental health services within the Improving Access to Psychological Therapies (IAPT) programme also contributed to service acceptability. However, limitations of Step 2 mental health service provision were also identified. Conclusion A Step 2 mental health service adapted for armed forces veterans and family members enhances acceptability and may potentially overcome help-seeking barriers. However, concerns remain regarding ways to accommodate the treatment of post-traumatic stress disorder and provide support for family members.Help for Heroe

Development and preliminary testing of the psychosocial adjustment to hereditary diseases scale

Background: The presence of Lynch syndrome (LS) can bring a lifetime of uncertainty to an entire family as members adjust to living with a high lifetime cancer risk. The research base on how individuals and families adjust to genetic-linked diseases following predictive genetic testing has increased our understanding of short-term impacts but gaps continue to exist in knowledge of important factors that facilitate or impede long-term adjustment. The failure of existing scales to detect psychosocial adjustment challenges in this population has led researchers to question the adequate sensitivity of these instruments. Furthermore, we have limited insight into the role of the family in promoting adjustment. Methods: The purpose of this study was to develop and initially validate the Psychosocial Adjustment to Hereditary Diseases (PAHD) scale. This scale consists of two subscales, the Burden of Knowing (BK) and Family Connectedness (FC). Items for the two subscales were generated from a qualitative data base and tested in a sample of 243 participants from families with LS. Results: The Multitrait/Multi-Item Analysis Program-Revised (MAP-R) was used to evaluate the psychometric properties of the PAHD. The findings support the convergent and discriminant validity of the subscales. Construct validity was confirmed by factor analysis and Cronbach’s alpha supported a strong internal consistency for BK (0.83) and FC (0.84). Conclusion: Preliminary testing suggests that the PAHD is a psychometrically sound scale capable of assessing psychosocial adjustment. We conclude that the PAHD may be a valuable monitoring tool to identify individuals and families who may require therapeutic interventions

Efficient Bayesian inference for natural time series using ARFIMA processes

Many geophysical quantities, such as atmospheric temperature, water levels in rivers, and wind speeds, have shown evidence of long memory (LM). LM implies that these quantities experience non-trivial temporal memory, which potentially not only enhances their predictability, but also hampers the detection of externally forced trends. Thus, it is important to reliably identify whether or not a system exhibits LM. In this paper we present a modern and systematic approach to the inference of LM. We use the flexible autoregressive fractional integrated moving average (ARFIMA) model, which is widely used in time series analysis, and of increasing interest in climate science. Unlike most previous work on the inference of LM, which is frequentist in nature, we provide a systematic treatment of Bayesian inference. In particular, we provide a new approximate likelihood for efficient parameter inference, and show how nuisance parameters (e.g., short-memory effects) can be integrated over in order to focus on long-memory parameters and hypothesis testing more directly. We illustrate our new methodology on the Nile water level data and the central England temperature (CET) time series, with favorable comparison to the standard estimators. For CET we also extend our method to seasonal long memory

Hubble flow variance and the cosmic rest frame

We characterize the radial and angular variance of the Hubble flow in the COMPOSITE sample of 4534 galaxies, on scales in which much of the flow is in the nonlinear regime. With no cosmological assumptions other than the existence of a suitably averaged linear Hubble law, we find with decisive Bayesian evidence (ln B >> 5) that the Hubble constant averaged in independent spherical radial shells is closer to its asymptotic value when referred to the rest frame of the Local Group, rather than the standard rest frame of the Cosmic Microwave Background. An exception occurs for radial shells in the range 40/h-60/h Mpc. Angular averages reveal a dipole structure in the Hubble flow, whose amplitude changes markedly over the range 32/h-62/h Mpc. Whereas the LG frame dipole is initially constant and then decreases significantly, the CMB frame dipole initially decreases but then increases. The map of angular Hubble flow variation in the LG rest frame is found to coincide with that of the residual CMB temperature dipole, with correlation coefficient -0.92. These results are difficult to reconcile with the standard kinematic interpretation of the motion of the Local Group in response to the clustering dipole, but are consistent with a foreground non-kinematic anisotropy in the distance-redshift relation of 0.5% on scales up to 65/h Mpc. Effectively, the differential expansion of space produced by nearby nonlinear structures of local voids and denser walls and filaments cannot be reduced to a local boost. This hypothesis suggests a reinterpretation of bulk flows, which may potentially impact on calibration of supernovae distances, anomalies associated with large angles in the CMB anisotropy spectrum, and the dark flow inferred from the kinematic Sunyaev-Zel'dovich effect. It is consistent with recent studies that find evidence for a non-kinematic dipole in the distribution of distant radio sources.Comment: 37 pages, 9 tables, 13 figures; v2 adds extensive new analysis (including additional subsections, tables, figures); v3 adds a Monte Carlo analysis (with additional table, figure) which further tightens the statistical robustness of the dipole results; v4 adds further clarifications, small corrections, references and discussion of Planck satellite results; v5 typos fixed, matches published versio

G92-1097 Root and Crown Rot: Winterkill Complex of Winter Wheat

Root and crown rot--winterkill complex is discussed, including nature of the complex, symptoms, control, and management rationale. Root and crown rot of winter wheat is an interrelated disease complex caused by the interaction of infection of roots and crowns by Bipolaris sorokiniana and/or Fusarium graminearum and harsh winter conditions. It is an insidious, persistent and inconspicuous disease complex that reduces wheat yields each year. In extreme cases, entire fields or large areas within fields are killed. The ultimate effect is loss of stands, poor plant vigor, reduced yield and lower grain quality

Enhanced Peculiar Velocities in Brane-Induced Gravity

The mounting evidence for anomalously large peculiar velocities in our Universe presents a challenge for the LCDM paradigm. The recent estimates of the large scale bulk flow by Watkins et al. are inconsistent at the nearly 3 sigma level with LCDM predictions. Meanwhile, Lee and Komatsu have recently estimated that the occurrence of high-velocity merging systems such as the Bullet Cluster (1E0657-57) is unlikely at a 6.5-5.8 sigma level, with an estimated probability between 3.3x10^{-11} and 3.6x10^{-9} in LCDM cosmology. We show that these anomalies are alleviated in a broad class of infrared-modifed gravity theories, called brane-induced gravity, in which gravity becomes higher-dimensional at ultra large distances. These theories include additional scalar forces that enhance gravitational attraction and therefore speed up structure formation at late times and on sufficiently large scales. The peculiar velocities are enhanced by 24-34% compared to standard gravity, with the maximal enhancement nearly consistent at the 2 sigma level with bulk flow observations. The occurrence of the Bullet Cluster in these theories is 10^4 times more probable than in LCDM cosmology.Comment: 15 pages, 6 figures. v2: added reference

Nurses\u27 Alumnae Association Bulletin, June 1969

Alumnae President\u27s Message Officers and Chairmen Financial Report Progressive Changes at Jefferson School of Nursing Report Student Activities School of Practical Nursing Report Jefferson Expansion Report Clerk-Typist Report Committee Reports Resume of Alumnae Meetings Class News 1969 CLINIC Correspondence Notice

The radial BAO scale and Cosmic Shear, a new observable for Inhomogeneous Cosmologies

As an alternative explanation of the dimming of distant supernovae it has recently been advocated that we live in a special place in the Universe near the centre of a large spherical void described by a Lemaitre-Tolman-Bondi (LTB) metric. In this scenario, the Universe is no longer homogeneous and isotropic, and the apparent late time acceleration is actually a consequence of spatial gradients. We propose in this paper a new observable, the normalized cosmic shear, written in terms of directly observable quantities, and calculable in arbitrary inhomogeneous cosmologies. This will allow future surveys to determine whether we live in a homogeneous universe or not. In this paper we also update our previous observational constraints from geometrical measures of the background cosmology. We include the Union Supernovae data set of 307 Type Ia supernovae, the CMB acoustic scale and the first measurement of the radial baryon acoustic oscillation scale. Even though the new data sets are significantly more constraining, LTB models -- albeit with slightly larger voids -- are still in excellent agreement with observations, at chi^2/d.o.f. = 307.7/(310-4)=1.005. Together with the paper we also publish the updated easyLTB code used for calculating the models and for comparing them to the observations.Comment: 18 pages, 8 figures, the code can be downloaded at http://www.phys.au.dk/~haugboel/software.shtm

Testing of the Crew Exploration Vehicle in NASA Langley's Unitary Plan Wind Tunnel

As part of a strategic, multi-facility test program, subscale testing of NASA s Crew Exploration Vehicle was conducted in both legs of NASA Langley s Unitary Plan Wind Tunnel. The objectives of these tests were to generate aerodynamic and surface pressure data over a range of supersonic Mach numbers and reentry angles of attack for experimental and computational validation and aerodynamic database development. To provide initial information on boundary layer transition at supersonic test conditions, transition studies were conducted using temperature sensitive paint and infrared thermography optical techniques. To support implementation of these optical diagnostics in the Unitary Wind Tunnel, the experiment was first modeled using the Virtual Diagnostics Interface software. For reentry orientations of 140 to 170 degrees (heat shield forward), windward surface flow was entirely laminar for freestream unit Reynolds numbers equal to or less than 3 million per foot. Optical techniques showed qualitative evidence of forced transition on the windward heat shield with application of both distributed grit and discreet trip dots. Longitudinal static force and moment data showed the largest differences with Mach number and angle of attack variations. Differences associated with Reynolds number variation and/or laminar versus turbulent flow on the heat shield were very small. Static surface pressure data supported the aforementioned trends with Mach number, Reynolds number, and angle of attack

'I-I' and 'I-me' : Transposing Buber's interpersonal attitudes to the intrapersonal plane

Hermans' polyphonic model of the self proposes that dialogical relationships can be established between multiple I-positions1 (e.g., Hermans, 2001a). There have been few attempts, however, to explicitly characterize the forms that these intrapersonal relationships may take. Drawing on Buber's (1958) distinction between the 'I-Thou' and 'I-It' attitude, it is proposed that intrapersonal relationships can take one of two forms: an 'I-I' form, in which one I-position encounters and confirms another I-position in its uniqueness and wholeness; and an 'I-Me' form, in which one I-position experiences another I-position in a detached and objectifying way. This article argues that this I-Me form of intrapersonal relating is associated with psychological distress, and that this is so for a number of reasons: Most notably, because an individual who objectifies and subjugates certain I-position cannot reconnect with more central I-positions when dominance reversal (Hermans, 2001a) takes place. On this basis, it is suggested that a key role of the therapeutic process is to help clients become more able to experience moments of I-I intrapersonal encounter, and it is argued that this requires the therapist to confirm the client both as a whole and in terms of each of his or her different voices