The identification and psychological treatment of panic disorder in adolescents: a survey of CAMHS clinicians

Background Panic disorder is experienced by around 1% of adolescents, and has a significant impact on social and academic functioning. Preliminary evidence supports the effectiveness of panic disorder specific treatment in adolescents with panic disorder, however panic disorder may be overlooked in adolescents due to overlapping symptoms with other anxiety disorders and other difficulties being more noticeable to others. The aim of this study was to establish what training National Health Service (NHS) Child and Adolescent Mental Health Services (CAMHS) clinicians have received in psychological therapies and panic disorder and how they identify and treat panic disorder in adolescents. Method CAMHS clinicians from a range of professions (n = 427), who were delivering psychological treatments to children and adolescents with anxiety disorders, participated. They completed a cross-sectional, online survey, including a vignette describing an adolescent with panic disorder, and were asked to identify the main diagnosis or presenting problem. Results Less than half the clinicians (48.6%) identified panic disorder or panic symptoms as the main presenting problem from the vignette. The majority of clinicians suggested CBT would be their treatment approach. However, few identified an evidence-based treatment protocol for working with young people with panic disorder. Almost half the sample had received no training in cognitive behaviour therapy (CBT) and around a fifth had received no training in delivering psychological treatments. Conclusions Only half of CAMHS clinicians identified panic disorder from a vignette and although CBT treatments are widely offered, only a minority of adolescents with panic disorder are receiving treatments developed for, and evaluated with young people with panic disorder. There is a vital need for clinician training, the use of tools that aid identification and the implementation of evidence-based treatments within CAMHS

Biased tomography schemes: an objective approach

We report on an intrinsic relationship between the maximum-likelihood quantum-state estimation and the representation of the signal. A quantum analogy of the transfer function determines the space where the reconstruction should be done without the need for any ad hoc truncations of the Hilbert space. An illustration of this method is provided by a simple yet practically important tomography of an optical signal registered by realistic binary detectors.Comment: 4 pages, 3 figures, accepted in PR

Variability Tests for Intrinsic Absorption Lines in Quasar Spectra

Quasar spectra have a variety of absorption lines whose origins range from energetic winds expelled from the central engines to unrelated, intergalactic clouds. We present multi-epoch, medium resolution spectra of eight quasars at z~2 that have narrow ``associated'' absorption lines (AALs, within $\pm$5000 km s^{-1} of the emission redshift). Two of these quasars were also known previously to have high-velocity mini-broad absorption lines (mini-BALs). We use these data, spanning ~17 years in the observed frame with two to four observations per object, to search for line strength variations as an identifier of absorption that occurs physically near (``intrinsic'' to) the central AGN. Our main results are the following: Two out of the eight quasars with narrow AALs exhibit variable AAL strengths. Two out of two quasars with high-velocity mini-BALs exhibit variable mini-BAL strengths. We also marginally detect variability in a high-velocity narrow absorption line (NAL) system, blueshifted \~32,900 km s^{-1}$ with respect to the emission lines. No other absorption lines in these quasars appeared to vary. The outflow velocities of the variable AALs are 3140 km s^{-1} and 1490 km s^{-1}. The two mini-BALs identify much higher velocity outflows of ~28,400 km s^{-1} and ~52,000 km s^{-1}. Our temporal sampling yields upper limits on the variation time scales from 0.28 to 6.1 years in the quasar rest frames. The corresponding minimum electron densities in the variable absorbers, based on the recombination time scale, are \~40,000 cm^{-3} to ~1900 cm^{-3}. The maximum distances of the absorbers from the continuum source, assuming photoionization with no spectral shielding, range from ~1.8 kpc to ~7 kpc.Comment: 16 pages, 4 figures, ApJ, accepte

Bystander B cells rapidly acquire antigen receptors from activated B cells by membrane transfer: a novel mechanism for enhancing specific antigen presentation

The B cell antigen receptor (BCR) efficiently facilitates the capture and processing of a specific antigen for presentation on MHC class II molecules to antigen specific CD4+ T cells (1). Despite this, the majority of B cells are only thought to play a limited role in CD4+ T cell activation since BCRs are clonotypically expressed. Here we show, however, that activated B cells can, both in vitro and in vivo, rapidly donate their BCR to bystander B cells, a process that is mediated by direct membrane transfer between adjacent B cells and is amplified by the interaction of the BCR with specific antigen. This results in a dramatic expansion in the number of antigen-binding B cells in vivo, with the transferred BCR endowing recipient B cells with the ability to present specific antigen to antigen-specific CD4+ T cells

Fertility control as a means of controlling bovine tuberculosis in badger (Meles meles) populations in south-west England: predictions from a spatial stochastic simulation model

A spatial stochastic simulation model was used to assess the potential of fertility control, based on a yet-to-be-developed oral bait-delivered contraceptive directed at females, for the control of bovine tuberculosis in badger populations in south-west England. The contraceptive had a lifelong effect so that females rendered sterile in any particular year remained so for the rest of their lives. The efficacy of fertility control alone repeated annually for varying periods of time was compared with a single culling operation and integrated control involving an initial single cull followed by annually repeated fertility control. With fertility control alone, in no instance was the disease eradicated completely while a viable badger population (mean group size of at least one individual) was still maintained. Near eradication of the disease (less than 1% prevalence) combined with the survival of a minimum viable badger population was only achieved under a very limited set of conditions, either with high efficiency of control (95%) over a short time period (1-3 years) or a low efficiency of control (20%) over an intermediate time period (10-20 years). Under these conditions, it took more than 20 years for the disease to decline to such low levels. A single cull of 80% efficiency succeeded in near eradication of the disease (below 1% prevalence) after a period of 6-8 years, while still maintaining a viable badger population. Integrated strategies reduced disease prevalence more rapidly and to lower levels than culling alone, although the mean badger group size following the onset of control was smaller. Under certain integrated strategies, principally where a high initial cull (80%) was followed by fertility control over a short (1-3 year) time period, the disease could be completely eradicated while a viable badger population was maintained. However, even under the most favourable conditions of integrated control, it took on average more than 12 years following the onset of control for the disease to disappear completely from the badger population. These results show that whilst fertility control would not be a successful strategy for the control of bovine tuberculosis in badgers if used alone, it could be effective if used with culling as part of an integrated strategy. This type of integrated strategy is likely to be more effective in terms of disease eradication than a strategy employing culling alone. However, the high cost of developing a suitable fertility control agent, combined with the welfare and conservation implications, are significant factors which should be taken into account when considering its possible use as a means of controlling bovine tuberculosis in badger populations in the UK

Temperature and Kinematics of CIV Absorption Systems

We use Keck HIRES spectra of three intermediate redshift QSOs to study the physical state and kinematics of the individual components of CIV selected heavy element absorption systems. Fewer than 8 % of all CIV lines with column densities greater than 10^{12.5} cm^{-2} have Doppler parameters b < 6 km/s. A formal decomposition into thermal and non-thermal motion using the simultaneous presence of SiIV gives a mean thermal Doppler parameter b_{therm}(CIV) = 7.2 km/s, corresponding to a temperature of 38,000 K although temperatures possibly in excess of 300,000 K occur occasionally. We also find tentative evidence for a mild increase of temperature with HI column density. Non-thermal motions within components are typically small (< 10 km/s) for most systems, indicative of a quiescent environment. The two-point correlation function (TPCF) of CIV systems on scales up to 500 km/s suggests that there is more than one source of velocity dispersion. The shape of the TPCF can be understood if the CIV systems are caused by ensembles of objects with the kinematics of dwarf galaxies on a small scale, while following the Hubble flow on a larger scale. Individual high redshift CIV components may be the building blocks of future normal galaxies in a hierarchical structure formation scenario.Comment: submitted to the ApJ Letters, March 16, 1996 (in press); (13 Latex pages, 4 Postscript figures, and psfig.sty included

Broad P V Absorption in the BALQSO, PG 1254+047: Column Densities, Ionizations and Metal Abundances in BAL Winds

This paper discusses the detection of P V 1118,1128 and other broad absorption lines (BALs) in archival HST spectra of the low-redshift BALQSO, PG 1254+047. The P V identification is secured by excellent redshift and profile coincidences with the other BALs, such as C IV 1548,1550 and Si IV 1393,1403, and by photoionization calculations showing that other lines near this wavelength, e.g. Fe III 1123, should be much weaker than P V. The observed BAL strengths imply that either 1) there are extreme abundance ratios such as [C/H] >~ +1.0, [Si/H] >~ +1.8 and [P/C] >~ +2.2, or 2) at least some of the lines are much more optically thick than they appear. I argue that the significant presence of P V absorption indicates severe line saturation, which is disguised in the observed (moderate-strength) BALs because the absorber does not fully cover the continuum source(s) along our line(s) of sight. Computed optical depths for all UV resonance lines show that the observed BALs are consistent with solar abundances if 1) the ionization parameter is at least moderately high, log U >~ -0.6, 2) the total hydrogen column density is log N_H(cm-2) >~ 22.0, and 3) the optical depths in strong lines like C IV and O VI 1032,1038 are >~25 and >~80, respectively. These optical depths and column densities are at least an order of magnitude larger than expected from the residual intensities in the BAL troughs, but they are consistent with the large absorbing columns derived from X-ray observations of BALQSOs. The outflowing BALR, at velocities from -15,000 to -27,000 km/s in PG 1254+047, is therefore a strong candidate for the X-ray absorber in BALQSOs.Comment: 16 pages (LaTeX) plus 8 pages of figures in one file (pg1254_figs.ps.gz), in press with Ap

Designing antibiotic cycling strategies by determining and understanding local adaptive landscapes

The evolution of antibiotic resistance among bacteria threatens our continued ability to treat infectious diseases. The need for sustainable strategies to cure bacterial infections has never been greater. So far, all attempts to restore susceptibility after resistance has arisen have been unsuccessful, including restrictions on prescribing [1] and antibiotic cycling [2,3]. Part of the problem may be that those efforts have implemented different classes of unrelated antibiotics, and relied on removal of resistance by random loss of resistance genes from bacterial populations (drift). Here, we show that alternating structurally similar antibiotics can restore susceptibility to antibiotics after resistance has evolved. We found that the resistance phenotypes conferred by variant alleles of the resistance gene encoding the TEM {\beta}-lactamase (blaTEM) varied greatly among 15 different {\beta}-lactam antibiotics. We captured those differences by characterizing complete adaptive landscapes for the resistance alleles blaTEM-50 and blaTEM-85, each of which differs from its ancestor blaTEM-1 by four mutations. We identified pathways through those landscapes where selection for increased resistance moved in a repeating cycle among a limited set of alleles as antibiotics were alternated. Our results showed that susceptibility to antibiotics can be sustainably renewed by cycling structurally similar antibiotics. We anticipate that these results may provide a conceptual framework for managing antibiotic resistance. This approach may also guide sustainable cycling of the drugs used to treat malaria and HIV

Atomic and molecular interstellar absorption lines toward the high galactic latitude stars HD~141569 and HD~157841 at ultra-high resolution

We present ultra-high resolution (0.32 km/s) spectra obtained with the 3.9m Anglo-Australian Telescope (AAT) and Ultra-High-Resolution Facility (UHRF), of interstellar NaI D1, D2, Ca II K, K I and CH absorption toward two high galactic latitude stars HD141569 and HD157841. We have compared our data with 21-cm observations obtained from the Leiden/Dwingeloo HI survey. We derive the velocity structure, column densities of the clouds represented by the various components and identify the clouds with ISM structures seen in the region at other wavelengths. We further derive abundances, linear depletions and H2 fractional abundances for these clouds, wherever possible. Toward HD141569, we detect two components in our UHRF spectra : a weak, broad component at - 15 km/s, seen only in CaII K absorption and another component at 0 km/s, seen in NaI D1, D2, Ca II K, KI and CH absorption. In the case of the HD157841 sightline, a total of 6 components are seen on our UHRF spectra in NaI D1, D2 Ca II K, K I and CH absorption. 2 of these 6 components are seen only in a single species.Comment: 16 pages, Latex, 4 figures, ps files Astrophysical Journal (in press

Remarkable dynamics of nanoparticles in the urban atmosphere

Nanoparticles emitted from road traffic are the largest source of respiratory exposure for the general public living in urban areas. It has been suggested that the adverse health effects of airborne particles may scale with the airborne particle number, which if correct, focuses attention on the nanoparticle (less than 100 nm) size range which dominates the number count in urban areas. Urban measurements of particle size distributions have tended to show a broadly similar pattern dominated by a mode centred on 20–30 nm diameter particles emitted by diesel engine exhaust. In this paper we report the results of measurements of particle number concentration and size distribution made in a major London park as well as on the BT Tower, 160 m high. These measurements taken during the REPARTEE project (Regents Park and BT Tower experiment) show a remarkable shift in particle size distributions with major losses of the smallest particle class as particles are advected away from the traffic source. In the Park, the traffic related mode at 20–30 nm diameter is much reduced with a new mode at <10 nm. Size distribution measurements also revealed higher number concentrations of sub-50 nm particles at the BT Tower during days affected by higher turbulence as determined by Doppler Lidar measurements and indicate a loss of nanoparticles from air aged during less turbulent conditions. These results suggest that nanoparticles are lost by evaporation, rather than coagulation processes. The results have major implications for understanding the impacts of traffic-generated particulate matter on human health