13,606 research outputs found
A qualitative exploration of patients' experience of mobile telephone‐delivered contingency management to promote adherence to supervised methadone
Introduction: Despite an increasing evidence base for mobile telephone‐delivered contingency management (mCM), there had been no previous qualitative exploration of patients' experience of receiving mCM and the factors that might influence that experience and outcome in a UK setting. The aim of this study was to understand patients' views and experience of receiving mCM by exploring their beliefs, expectations and perceived benefits within the context of the UK's first mCM intervention. Methods: Qualitative interviews (N = 15) were conducted with patients undergoing opioid agonist treatment in a UK drug treatment service and receiving mCM to encourage adherence with supervised methadone as part of an existing study. Interviews were conducted at two time points and analysed using Framework to explore patients' expectations and beliefs during the early stage of the intervention (2 weeks) and their perceived benefits and experience at the end of the intervention (12 weeks). Results: The mCM was perceived as a motivator, providing validation of achievement, and involving discreet and positive interactions. Perceived benefits included enhanced methadone adherence, reduced drug use and the development of a supportive and non‐judgemental connection that resembled a therapeutic alliance. Discussion and Conclusions: The mechanisms underpinning contingency management appeared to operate in the absence of human interaction, and the mCM intervention was deemed to be meaningful, acceptable and well received by patients. These findings not only provide support for the application of mCM in this context but also offer insight into the factors that influence outcomes and should be considered in the development of future mCM interventions
Warm absorber, reflection and Fe K line in the X-ray spectrum of IC 4329A
Results from the X-ray spectral analysis of the ASCA PV phase observation of
the Seyfert 1 galaxy IC 4329A are presented. We find that the 0.4 - 10 keV
spectrum of IC 4329A is best described by the sum of a steep () power-law spectrum passing through a warm absorber plus a strong
reflection component and associated Fe K line, confirming recent results
(Madejski et al. 1995, Mushotsky et al. 1995). Further cold absorption in
excess of the Galactic value and covering the entire source is also required by
the data, consistent with the edge-on galactic disk and previous X-ray
measurements. The effect of the warm absorber at soft X-ray energies is best
parameterized by two absorption edges, one consistent with OVI, OVII or NVII,
the other consistent with OVIII. A description of the soft excess in terms of
blackbody emission, as observed in some other Seyfert 1 galaxies, is ruled out
by the data. A large amount of reflection is detected in both the GIS and SIS
detectors, at similar intensities. We find a strong correlation between the
amount of reflection and the photon index, but argue that the best solution
with the present data is that given by the best statistical fit. The model
dependence of the Fe K line parameters is also discussed. Our best fit gives a
slightly broad ( keV) and redshifted (E keV) Fe K line, with equivalent width 89 33 eV.
The presence of a weak Fe K line with a strong reflection can be reconciled if
one assumes iron underabundances or ionized reflection. We also have modeled
the line with a theoretical line profile produced by an accretion disk. This
yields results in better agreement with the constraints obtained from the
reflection component.Comment: Accepted for publication in The Astrophysical Journal, 10th February
1996 issue; 24 pages and 8 figures + 1 table tared, compressed and uuencoded
(with uufiles
Stem-Cell-like Qualities of Immune Memory; CD4+ T Cells Join the Party
Similar to hematopoietic stem cells, memory lymphocytes self-renew, while their clonally expanded effector progeny differentiate to fight infection and tumors. Recently, Muranski et al. (2011) report in Immunity that a subset of Th17 effector cells function as memory cells and retain stem cell properties
Experiences of parenting and clinical intervention for mothers affected by personality disorder: a pilot qualitative study combining parent and clinician perspectives
Background: Evidence-based parenting programmes are recommended for the treatment of child mental health difficulties. Families with complex psychosocial needs show poorer retention and outcomes when participating in standard parenting programmes. The Helping Families Programme (HFP) is a 16-week community-based parenting intervention designed to meet the needs of these families, including families with parental personality disorder. This study aimed to explore the help seeking and participatory experiences of parents with a diagnosis of personality disorder. It further aimed to examine the acceptability of referral and intervention processes for the HFP from the perspectives of (i) clinicians referring into the programme; and (ii) referred parents.
Method: Semi-structured interviews were conducted with parents recruited to receive HFP (n = 5) as part of a research case series and the referring NHS child and adolescent mental health service (CAMHS) clinicians (n = 5). Transcripts were analysed using Interpretive Phenomenological Analysis.
Results: Four themes were identified for parents: (i) the experience of parenthood, (ii) being a parent affected by personality disorder, (iii) experience of the intervention, and (iv) qualities of helping. Three themes emerged for clinicians: (i) challenges of addressing parental need, (ii) experience of engaging parents with personality disorders and (iii) limited involvement during HFP. Comparison of parent and clinician themes led to the identification of two key interlinked themes: (i) concerns prior to receiving the intervention, and (ii) the challenges of working together without a mutual understanding.
Conclusions: This pilot study identifies potentially significant challenges of working with parents affected by personality disorder and engaging them in HFP and other similar interventions. Results have important wider clinical implications by highlighting potential barriers to engagement and participation and providing insights on how these barriers might be overcome. Findings have been used to inform the referral and intervention processes of a pilot RCT and further intervention development
The Design, Testing, and Implementation of a Halon 1301 Fire Extinguishment System for Use in the Service Lunar Adapter at KSC Launch Complex 39
Since the advent of hypergolic fuels usage at the Kennedy Space Center and the Kennedy Air Force Station, personnel safety during fueling operations has been provided by limiting the number of persons having access to hazardous areas to those who were essential to the operation, and by providing these people with protective clothing.
With the Apollo Program, a new problem has introduced itself; the Lunar Module (LM) (Fig. 1) is actually two launch vehicles which leave the launch pad as part of the Apollo payload. Fueling of these launch vehicles takes place approximately two weeks before the launch of the Apollo/Saturn V. Personnel are required to continue servicing the LM after fueling; this requires them to be enclosed within the Saturn/ Lunar Module Adapter (SLA) . Special egress equipment has been installed but will not be discussed in this presentation.
To minimize the hazard of a flash fire resulting from the ignition of a spilled hypergol, a Halon 1301 (bromotriflouromethane) protection system has been designed and has been available during the launches of AS-204 and AS-504. Since improvements over the original system which was installed at Launch Complex 37 were incorporated into the design of the system for Launch Complex 39, our discussion will deal only with the Launch Complex 39 system
How to Find More Supernovae with Less Work: Object Classification Techniques for Difference Imaging
We present the results of applying new object classification techniques to
difference images in the context of the Nearby Supernova Factory supernova
search. Most current supernova searches subtract reference images from new
images, identify objects in these difference images, and apply simple threshold
cuts on parameters such as statistical significance, shape, and motion to
reject objects such as cosmic rays, asteroids, and subtraction artifacts.
Although most static objects subtract cleanly, even a very low false positive
detection rate can lead to hundreds of non-supernova candidates which must be
vetted by human inspection before triggering additional followup. In comparison
to simple threshold cuts, more sophisticated methods such as Boosted Decision
Trees, Random Forests, and Support Vector Machines provide dramatically better
object discrimination. At the Nearby Supernova Factory, we reduced the number
of non-supernova candidates by a factor of 10 while increasing our supernova
identification efficiency. Methods such as these will be crucial for
maintaining a reasonable false positive rate in the automated transient alert
pipelines of upcoming projects such as PanSTARRS and LSST.Comment: 25 pages; 6 figures; submitted to Ap
Mobile telephone-delivered contingency management interventions promoting behaviour change in individuals with substance use disorders: a meta-analysis
BACKGROUND/AIMS:
Contingency management (CM) interventions have gained considerable interest due to their success in the treatment of addiction. However, their implementation can be resource-intensive for clinical staff. Mobile telephone-based systems might offer a low-cost alternative. This approach could facilitate remote monitoring of behaviour and delivery of the reinforcer and minimize issues of staffing and resources. This systematic review and meta-analysis assessed the evidence for the effectiveness of mobile telephone-delivered CM interventions to promote abstinence (from drugs, alcohol and tobacco), medication adherence and treatment engagement among individuals with substance use disorders.
DESIGN:
A systematic search of databases (PsychINFO, CINAHL, MEDLINE PubMed, CENTRAL, Embase) for randomized controlled trials and within-subject design studies (1995-2019). The review was conducted in accordance with the PRISMA statement. The protocol was registered on PROSPERO.
SETTING:
All included studies originated in the United states.
PARTICIPANTS:
Seven studies were found, including 222 participants; two targeted alcohol abstinence among frequent drinkers and four targeted smoking cessation (in homeless veterans and those with post-traumatic stress disorder). One targeted medication adherence.
MEASURES:
The efficacy of CM to increase alcohol and nicotine abstinence was compared with control using several outcomes; percentage of negative samples (PNS), quit rate (QR) and longest duration abstinent (LDA) at the end of the intervention.
FINDINGS:
The random-effects meta-analyses produced pooled effect sizes of; PNS [d = 0.94, 95% confidence interval (CI) = 0.63-1.25], LDA (d = 1.08, 95% CI = 0.69-1.46) and QR (d = 0.46, 95% CI = 0.27-0.66), demonstrating better outcomes across the CM conditions. Most of the studies were rated as of moderate quality. 'Fail-safe N' computations for PNS indicated that 50 studies would be needed to produce a non-significant overall effect size. None could be calculated for QR and LDA due to insufficient number of studies.
CONCLUSION:
Mobile telephone-delivered contingency management performs significantly better than control conditions in reducing tobacco and alcohol use among adults not in treatment for substance use disorders
A trivial observation on time reversal in random matrix theory
It is commonly thought that a state-dependent quantity, after being averaged
over a classical ensemble of random Hamiltonians, will always become
independent of the state. We point out that this is in general incorrect: if
the ensemble of Hamiltonians is time reversal invariant, and the quantity
involves the state in higher than bilinear order, then we show that the
quantity is only a constant over the orbits of the invariance group on the
Hilbert space. Examples include fidelity and decoherence in appropriate models.Comment: 7 pages 3 figure
Scalability considerations for multivariate graph visualization
Real-world, multivariate datasets are frequently too large to show in their entirety on a visual display. Still, there are many techniques we can employ to show useful partial views-sufficient to support incremental exploration of large graph datasets. In this chapter, we first explore the cognitive and architectural limitations which restrict the amount of visual bandwidth available to multivariate graph visualization approaches. These limitations afford several design approaches, which we systematically explore. Finally, we survey systems and studies that exhibit these design strategies to mitigate these perceptual and architectural limitations
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