The efficacy of problem-solving treatments after deliberate self-harm: meta-analysis of randomized controlled trials with respect to depression, hopelessness and improvement in problems

Background. Brief problem-solving therapy is regarded as a pragmatic treatment for deliberate self-harm (DSH) patients. A recent meta-analysis of randomized controlled trials (RCTs) evaluating this approach indicated a trend towards reduced repetition of DSH but the pooled odds ratio was not statistically significant. We have now examined other important outcomes using this procedure, namely depression, hopelessness and improvement in problems. Method. Six trials in which problem-solving therapy was compared with control treatment were identified from an extensive literature review of RCTs of treatments for DSH patients. Data concerning depression, hopelessness and improvement in problems were extracted. Where relevant statistical data (e.g. standard deviations) were missing these were imputed using various statistical methods. Results were pooled using meta-analytical procedures. Results. At follow-up, patients who were offered problem-solving therapy had significantly greater improvement in scores for depression (standardized mean difference =[minus sign]0·36; 95% CI [minus sign]0·61 to [minus sign]0·11) and hopelessness (weighted mean difference =[minus sign]3·2; 95% CI [minus sign]4·0 to [minus sign]2·41), and significantly more reported improvement in their problems (odds ratio = 2·31; 95% CI 1·29 to 4·13), than patients who were in the control treatment groups. Conclusions. Problem-solving therapy for DSH patients appears to produce better results than control treatment with regard to improvement in depression, hopelessness and problems. It is desirable that this finding is confirmed in a large trial, which will also allow adequate testing of the impact of this treatment on repetition of DSH

Evaluation of milk yield losses associated with Salmonella antibodies in bulk-tank milk in bovine dairy herds

The effect of Salmonella on milk production is not well established in cattle. The objective of this study was to investigate whether introduction of Salmonella into dairy cattle herds was associated with reduced milk yield and the duration of any effect. Longitudinal data from 2005 through 2009 were used, with data from 12 months before until 18 months after the estimated date of infection. Twenty-eight case herds were selected based on an increase in the level of Salmonella specific antibodies in bulk-tank milk from < 10 corrected optic density percentage (ODC%) to ≥ 70 ODC% between two consecutive 3-monthly measurements in the Danish Salmonella surveillance program. All selected case herds were conventional Danish Holstein herds. Control herds (n = 40) were selected randomly from Danish Holstein herds with Salmonella antibody levels consistently < 10 ODC%. A date of herd infection was randomly allocated to the control herds. Hierarchical mixed effect models with the outcome test day energy corrected milk yield (ECM)/cow were used to investigate the daily milk yield before and after the estimated herd infection date for cows in parity 1, 2 and 3+. Control herds were used to evaluate whether the effects in the case herds could be reproduced in herds without Salmonella infection. Herd size, days in milk, somatic cell count, season, and year were included in the models. The key results were that first parity cow yield was reduced by a mean of 1.4 kg (95% CI: 0.5 to 2.3) ECM/cow per day from seven to 15 months after the estimated herd infection date, compared with first parity cows in the same herds in the 12 months before the estimated herd infection date. Yield for parity 3+ was reduced by a mean of 3.0 kg (95% CI: 1.3 to 4.8) ECM/cow per day from seven to 15 months after herd infection compared with parity 3+ cows in the 12 months before the estimated herd infection. There were minor differences in yield in second parity cows before and after herd infection, and no difference between cows in control herds before and after the simulated infection date. There was a significant drop in milk yield in affected herds and the reduction was detectable several months after the increase in bulk-tank milk Salmonella antibodies. It took more than a year for milk yield to return to pre- infection levels

Modelling the impact of local reactive school closures on critical care provision during an influenza pandemic

Despite the fact that the 2009 H1N1 pandemic influenza strain was less severe than had been feared, both seasonal epidemics of influenza-like-illness and future influenza pandemics have the potential to place a serious burden on health services. The closure of schools has been postulated as a means of reducing transmission between children and hence reducing the number of cases at the peak of an epidemic; this is supported by the marked reduction in cases during school holidays observed across the world during the 2009 pandemic. However, a national policy of long-duration school closures could have severe economic costs. Reactive short-duration closure of schools in regions where health services are close to capacity offers a potential compromise, but it is unclear over what spatial scale and time frame closures would need to be made to be effective. Here, using detailed geographical information for England, we assess how localized school closures could alleviate the burden on hospital intensive care units (ICUs) that are reaching capacity. We show that, for a range of epidemiologically plausible assumptions, considerable local coordination of school closures is needed to achieve a substantial reduction in the number of hospitals where capacity is exceeded at the peak of the epidemic. The heterogeneity in demand per hospital ICU bed means that even widespread school closures are unlikely to have an impact on whether demand will exceed capacity for many hospitals. These results support the UK decision not to use localized school closures as a control mechanism, but have far wider international public-health implications. The spatial heterogeneities in both population density and hospital capacity that give rise to our results exist in many developed countries, while our model assumptions are sufficiently general to cover a wide range of pathogens. This leads us to believe that when a pandemic has severe implications for ICU capacity, only widespread school closures (with their associated costs and organizational challenges) are sufficient to mitigate the burden on the worst-affected hospitals

Leader self-sacrifice and leadership effectiveness: The moderating role of leader prototypicality

Self-sacrificing behavior of the leader and the extent to which the leader is representative of the group (i.e., group prototypical) are proposed to interact to influence leadership effectiveness. The authors expected self-sacrificing leaders to be considered more effective and to be able to push subordinates to a higher performance level than non-self-sacrificing leaders, and these effects were expected to be more pronounced for less prototypical leaders than for more prototypical leaders. The results of a laboratory experiment showed that, as expected, productivity levels, effectiveness ratings, and perceived leader group-orientedness and charisma were positively affected by leader self-sacrifice, especially when leader prototypicality was low, The main results were replicated in a scenario experiment and 2 surveys

Proposed new reactor-activated positron source for intense slow e+ beam production

A novel method is suggested for producing a new positron (e+) emitting isotope in a nuclear reactor with application to slow e+ beams. The initial radiated sample is 124Xe which is transformed to 126I by two neutron absorptions and an intermediate decay. Over 25 Ci of positrons with a specific activity of 25 Ci/gm can be produced by this technique, allowing the generation of a slow e+ beam of over 4 x 107 e+/cm2 -s. As discussed in the conclusion, specific activities approaching 200 Ci/gm should be for activation cells are presented, one with Xe in the gas phase, the other with solid Xe. Both designs allow the easy separation of the 126I from other contaminants, permitting the production of a pure, high specific activity source.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/27384/1/0000415.pd

Limits on asymmetric orthopositronium formation in high Z optically active molecules

The proposed connection between the parity violating handedness of beta particles in radioactive decay and the sign (L) of biological chirality (the Vester-Ulbricht [V-U] hypothesis) is experimentally tested. The theoretically predicted asymmetry in triplet positronium formation ( A Ps ) is measured in several high Z optically active molecules using low energy positrons with a net helicity. We find A Ps A Ps >2×10 −6 in these molecules. The connection between these limits and limits on asymmetric radiolysis ( A R ) is made, with a new limit of A R >10 −9 being placed. This limit on A R , which is thirty times lower than a previous measurement in the amino acid leucine ( Z =6), is still not small enough to rule out the V-U hypothesis.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43348/1/11084_2005_Article_BF01808051.pd

The Extraction of Community Structures from Publication Networks to Support Ethnographic Observations of Field Differences in Scientific Communication

The scientific community of researchers in a research specialty is an important unit of analysis for understanding the field specific shaping of scientific communication practices. These scientific communities are, however, a challenging unit of analysis to capture and compare because they overlap, have fuzzy boundaries, and evolve over time. We describe a network analytic approach that reveals the complexities of these communities through examination of their publication networks in combination with insights from ethnographic field studies. We suggest that the structures revealed indicate overlapping sub- communities within a research specialty and we provide evidence that they differ in disciplinary orientation and research practices. By mapping the community structures of scientific fields we aim to increase confidence about the domain of validity of ethnographic observations as well as of collaborative patterns extracted from publication networks thereby enabling the systematic study of field differences. The network analytic methods presented include methods to optimize the delineation of a bibliographic data set in order to adequately represent a research specialty, and methods to extract community structures from this data. We demonstrate the application of these methods in a case study of two research specialties in the physical and chemical sciences.Comment: Accepted for publication in JASIS