634 research outputs found
Creation and validation of a new tool for the monitoring efficacy of neurogenic bowel dysfunction treatment on response: the MENTOR tool
STUDY DESIGN: Prospective observational study. OBJECTIVES: A tool to help decision-making tool for Neurogenic Bowel Dysfunction (NBD) in individuals with SCI is needed. We present a project to create and validate a new tool, the Monitoring Efficacy of NBD Treatment On Response (MENTOR), and to determine its level of concordance with decisions made by experienced clinicians in the field. SETTING: UK, Denmark, USA, Italy, The Netherlands, Germany. METHODS: The first phase was creation of the tool through a modified Delphi process. The second phase was the validation, wherein individuals with spinal cord injury with NBD were asked to complete the MENTOR tool immediately prior to clinic consultation. From the responses to the questionnaire of the tool, each participant was allocated into one of three categories reflecting the possible therapeutic recommendations ("recommend change", "further discussion" and "monitoring"). An expert clinician then assessed the participant, blinded to MENTOR results, and made an independent treatment decision. RESULTS: A total of 248 MENTOR forms were completed. Strong agreement was found when the MENTOR tool recommended monitoring (92%) or treatment change (83%); the lowest concordance when the decision was for the "further discussion" option (59%). Patient acceptability was reported by 97% of individuals. CONCLUSIONS: MENTOR is an easy to use tool to monitor the treatment of NBD and determinate progression through the clinical pathway. This validation study shows good correspondence between expert clinician opinion and MENTOR result. The tool has potential to be used in other patient groups, following further studies
Mental health first aid training in a workplace setting: A randomized controlled trial [ISRCTN13249129]
BACKGROUND: The Mental Health First Aid training course was favorably evaluated in an uncontrolled trial in 2002 showing improvements in participants' mental health literacy, including knowledge, stigmatizing attitudes, confidence and help provided to others. This article reports the first randomized controlled trial of this course. METHODS: Data are reported on 301 participants randomized to either participate immediately in a course or to be wait-listed for 5 months before undertaking the training. The participants were employees in two large government departments in Canberra, Australia, where the courses were conducted during participants' work time. Data were analyzed according to an intention-to-treat approach. RESULTS: The trial found a number of benefits from this training course, including greater confidence in providing help to others, greater likelihood of advising people to seek professional help, improved concordance with health professionals about treatments, and decreased stigmatizing attitudes. An additional unexpected but exciting finding was an improvement in the mental health of the participants themselves. CONCLUSIONS: The Mental Health First Aid training has shown itself to be not only an effective way to improve participants' mental health literacy but also to improve their own mental health. It is a course that has high applicability across the community
Experimental loophole-free violation of a Bell inequality using entangled electron spins separated by 1.3 km
For more than 80 years, the counterintuitive predictions of quantum theory
have stimulated debate about the nature of reality. In his seminal work, John
Bell proved that no theory of nature that obeys locality and realism can
reproduce all the predictions of quantum theory. Bell showed that in any local
realist theory the correlations between distant measurements satisfy an
inequality and, moreover, that this inequality can be violated according to
quantum theory. This provided a recipe for experimental tests of the
fundamental principles underlying the laws of nature. In the past decades,
numerous ingenious Bell inequality tests have been reported. However, because
of experimental limitations, all experiments to date required additional
assumptions to obtain a contradiction with local realism, resulting in
loopholes. Here we report on a Bell experiment that is free of any such
additional assumption and thus directly tests the principles underlying Bell's
inequality. We employ an event-ready scheme that enables the generation of
high-fidelity entanglement between distant electron spins. Efficient spin
readout avoids the fair sampling assumption (detection loophole), while the use
of fast random basis selection and readout combined with a spatial separation
of 1.3 km ensure the required locality conditions. We perform 245 trials
testing the CHSH-Bell inequality and find . A
null hypothesis test yields a probability of that a local-realist
model for space-like separated sites produces data with a violation at least as
large as observed, even when allowing for memory in the devices. This result
rules out large classes of local realist theories, and paves the way for
implementing device-independent quantum-secure communication and randomness
certification.Comment: Raw data will be made available after publicatio
Asteroseismology and Interferometry
Asteroseismology provides us with a unique opportunity to improve our
understanding of stellar structure and evolution. Recent developments,
including the first systematic studies of solar-like pulsators, have boosted
the impact of this field of research within Astrophysics and have led to a
significant increase in the size of the research community. In the present
paper we start by reviewing the basic observational and theoretical properties
of classical and solar-like pulsators and present results from some of the most
recent and outstanding studies of these stars. We centre our review on those
classes of pulsators for which interferometric studies are expected to provide
a significant input. We discuss current limitations to asteroseismic studies,
including difficulties in mode identification and in the accurate determination
of global parameters of pulsating stars, and, after a brief review of those
aspects of interferometry that are most relevant in this context, anticipate
how interferometric observations may contribute to overcome these limitations.
Moreover, we present results of recent pilot studies of pulsating stars
involving both asteroseismic and interferometric constraints and look into the
future, summarizing ongoing efforts concerning the development of future
instruments and satellite missions which are expected to have an impact in this
field of research.Comment: Version as published in The Astronomy and Astrophysics Review, Volume
14, Issue 3-4, pp. 217-36
Standardisation of intestinal ultrasound scoring in clinical trials for luminal Crohn's disease
Background: Intestinal ultrasound (IUS) is a valuable tool for assessment of Crohn’s disease (CD). However, there is no widely accepted luminal disease activity index. /
Aims: To identify appropriate IUS protocols, indices, items, and scoring methods for measurement of luminal CD activity and integration of IUS in CD clinical trials. /
Methods: An expert international panel of adult and paediatric gastroenterologists (n = 15) and radiologists (n = 3) rated the appropriateness of 120 statements derived from literature review and expert opinion (scale of 1-9) using modified RAND/UCLA methodology. Median panel scores of 1 to ≤3.5, >3.5 to <6.5 and ≥6.5 to 9 were considered inappropriate, uncertain and appropriate ratings respectively. The statement list and survey results were discussed prior to voting. /
Results: A total of 91 statements were rated appropriate with agreement after two rounds of voting. Items considered appropriate measures of disease activity were bowel wall thickness (BWT), vascularity, stratification and mesenteric inflammatory fat. There was uncertainty if any of the existing IUS disease activity indices were appropriate for use in CD clinical trials. Appropriate trial applications for IUS included patient recruitment qualification when diseased segments cannot be adequately assessed by ileocolonoscopy and screening for exclusionary complications. At outcome assessment, remission endpoints including BWT and vascularity, with or without mesenteric inflammatory fat, were considered appropriate. Components of an ideal IUS disease activity index were identified based upon panel discussions. /
Conclusions: The panel identified appropriate component items and applications of IUS for CD clinical trials. Empiric evidence, and development and validation of an IUS disease activity index are needed
Effects of mental health self-efficacy on outcomes of a mobile phone and web intervention for mild-to-moderate depression, anxiety and stress: secondary analysis of a randomised controlled trial.
Background:
Online psychotherapy is clinically effective yet why, how, and for whom the effects are greatest remain largely unknown. In the present study, we examined whether mental health self-efficacy (MHSE), a construct derived from Bandura’s Social Learning Theory (SLT), influenced symptom and functional outcomes of a new mobile phone and web-based psychotherapy intervention for people with mild-to-moderate depression, anxiety and stress.
Methods:
STUDY I: Data from 49 people with symptoms of depression, anxiety and/or stress in the mild-to-moderate range were used to examine the reliability and construct validity of a new measure of MHSE, the Mental Health Self-efficacy Scale (MHSES). STUDY II: We conducted a secondary analysis of data from a recently completed randomised controlled trial (N = 720) to evaluate whether MHSE effected post-intervention outcomes, as measured by the Depression, Anxiety and Stress Scales (DASS) and Work and Social Adjustment Scale (WSAS), for people with symptoms in the mild-to-moderate range.
Results:
STUDY I: The data established that the MHSES comprised a unitary factor, with acceptable internal reliability (Cronbach’s alpha = .89) and construct validity. STUDY II: The intervention group showed significantly greater improvement in MHSE at post-intervention relative to the control conditions (p’s < = .000). MHSE mediated the effects of the intervention on anxiety and stress symptoms. Furthermore, people with low pre-treatment MHSE reported the greatest post-intervention gains in depression, anxiety and overall distress. No effects were found for MHSE on work and social functioning.
Conclusion:
Mental health self-efficacy influences symptom outcomes of a self-guided mobile phone and web-based psychotherapeutic intervention and may itself be a worthwhile target to increase the effectiveness and efficiency of online treatment programs
Testing foundations of quantum mechanics with photons
The foundational ideas of quantum mechanics continue to give rise to
counterintuitive theories and physical effects that are in conflict with a
classical description of Nature. Experiments with light at the single photon
level have historically been at the forefront of tests of fundamental quantum
theory and new developments in photonics engineering continue to enable new
experiments. Here we review recent photonic experiments to test two
foundational themes in quantum mechanics: wave-particle duality, central to
recent complementarity and delayed-choice experiments; and Bell nonlocality
where recent theoretical and technological advances have allowed all
controversial loopholes to be separately addressed in different photonics
experiments.Comment: 10 pages, 5 figures, published as a Nature Physics Insight review
articl
Towards a realistic interpretation of quantum mechanics providing a model of the physical world
It is argued that a realistic interpretation of quantum mechanics is possible
and useful. Current interpretations, from Copenhagen to many worlds are
critically revisited. The difficulties for intuitive models of quantum physics
are pointed out and possible solutions proposed. In particular the existence of
discrete states, the quantum jumps, the alleged lack of objective properties,
measurement theory, the probabilistic character of quantum physics, the
wave-particle du- ality and the Bell inequalities are analyzed. The sketch of a
realistic picture of the quantum world is presented. It rests upon the assump-
tion that quantum mechanics is a stochastic theory whose randomness derives
from the existence of vacuum fields. They correspond to the vacuum fluctuations
of quantum field theory, but taken as real rather than virtual.Comment: 43 pages, paper throughout revised and somewhat enlarged, sections on
the Bell inequalities and on the sketch of a picture of the quantum world
rewritten, new references adde
Bio-nanotechnology application in wastewater treatment
The nanoparticles have received high interest in the field of medicine and water purification, however, the nanomaterials produced by chemical and physical methods are considered hazardous, expensive, and leave behind harmful substances to the environment. This chapter aimed to focus on green-synthesized nanoparticles and their medical applications. Moreover, the chapter highlighted the applicability of the metallic nanoparticles (MNPs) in the inactivation of microbial cells due to their high surface and small particle size. Modifying nanomaterials produced by green-methods is safe, inexpensive, and easy. Therefore, the control and modification of nanoparticles and their properties were also discussed
Structure and function of mammalian cilia
In the past half century, beginning with electron microscopic studies of 9 + 2 motile and 9 + 0 primary cilia, novel insights have been obtained regarding the structure and function of mammalian cilia. All cilia can now be viewed as sensory cellular antennae that coordinate a large number of cellular signaling pathways, sometimes coupling the signaling to ciliary motility or alternatively to cell division and differentiation. This view has had unanticipated consequences for our understanding of developmental processes and human disease
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