Therapeutic Homework to Support Recovery From Severe Mental Illness

Therapeutic homework refers to activities that clients complete between their visits with mental health workers. The aim of such homework is to facilitate progress toward h\u27eatment goals. There is an increasing body of research indicating that homework completion is associated with improved outcomes of psychotherapy across a wide range of clinical disorders (such as depression and anxiety). However, there is limited research into the role of homework in mental health case management for people with severe mental illnesses such as schizophrenia

Growth and Empowerment for Indigenous Australians in Substance Abuse Treatment

This paper describes psychosocial outcomes of an Indigenous residential substance abuse rehabilitation centre in Australia, examines the sensitivity to change of the new Growth and Empowerment Measure (GEM), and explores the degree to which service users value cultural components of the treatment program. Participants were 57 Indigenous and 46 non-Indigenous male clients from Oolong House. Intake, 8-weeks, and 16-weeks (program completion) measures of Kessler 10 Psychological Distress Scale (K10), Drug Taking Confidence Questionnaire (DTCQ-8), and GEM were completed. The Treatment Component Evaluation (TCE) was completed at 16-weeks. There were significant improvements for participants, with a decrease in psychological distress and increases in refusal self-efficacy and empowerment. Effect sizes for GEM were medium to large across the time-points (r00.61 to 0.70 for all four subscales from baseline to 8-weeks; r00.44 to 0.70 for three subscales from 8-weeks to 16-weeks), indicating sensitivity to change. Indigenous participants rated cultural components of treatment significantly more helpful than did non-Indigenous participants. Implications for future research and substance abuse interventions for Indigenous Australians are discussed

Epidemiologic aspects of the malaria transmission cycle in an area of very low incidence in Brazil

BACKGROUND: Extra-Amazonian autochthonous Plasmodium vivax infections have been reported in mountainous regions surrounded by the Atlantic Forest in Espírito Santo state, Brazil. METHODS: Sixty-five patients and 1,777 residents were surveyed between April 2001 and March 2004. Laboratory methods included thin and thick smears, multiplex-PCR, immunofluorescent assay (IFA) against P. vivax and Plasmodium malariae crude blood-stage antigens and enzyme-linked immunosorbent assay (ELISA) for antibodies against the P. vivax-complex (P. vivax and variants) and P. malariae/Plasmodium brasilianum circumsporozoite-protein (CSP) antigens. RESULTS: Average patient age was 35.1 years. Most (78.5%) were males; 64.6% lived in rural areas; 35.4% were farmers; and 12.3% students. There was no relevant history of travel. Ninety-five per cent of the patients were experiencing their first episode of malaria. Laboratory data from 51 patients were consistent with P. vivax infection, which was determined by thin smear. Of these samples, 48 were assayed by multiplex-PCR. Forty-five were positive for P. vivax, confirming the parasitological results, while P. malariae was detected in one sample and two gave negative results. Fifty percent of the 50 patients tested had IgG antibodies against the P. vivax-complex or P. malariae CSP as determined by ELISA. The percentages of residents with IgM and IgG antibodies detected by IFA for P. malariae, P. vivax and Plasmodium falciparum who did not complain of malaria symptoms at the time blood was collected were 30.1% and 56.5%, 6.2% and 37.7%, and 13.5% and 13%, respectively. The same sera that reacted to P. vivax also reacted to P. malariae. The following numbers of samples were positive in multiplex-PCR: 23 for P. vivax; 15 for P. malariae; 9 for P. falciparum and only one for P. falciparum and P. malariae. All thin and thick smears were negative. ELISA against CSP antigens was positive in 25.4%, 6.3%, 10.7% and 15.1% of the samples tested for "classical" P. vivax (VK210), VK247, P. vivax-like and P. malariae, respectively. Anopheline captures in the transmission area revealed only zoophilic and exophilic species. CONCLUSION: The low incidence of malaria cases, the finding of asymptomatic inhabitants and the geographic separation of patients allied to serological and molecular results raise the possibility of the existence of a simian reservoir in these areas

MESMER: MeerKAT Search for Molecules in the Epoch of Reionization

[Abridged] Observations of molecular gas at all redshifts are critical for measuring the cosmic evolution in molecular gas density and understanding the star-formation history of the Universe. The 12CO molecule (J=1-0 transition = 115.27 GHz) is the best proxy for extragalactic H2, which is the gas reservoir from which star formation occurs, and has been detected out to z~6. Typically, redshifted high-J lines are observed at mm-wavelengths, the most commonly targeted systems exhibiting high SFRs (e.g. submm galaxies), and far-IR-bright QSOs. While the most luminous objects are the most readily observed, detections of more typical galaxies with modest SFRs are essential for completing the picture. ALMA will be revolutionary in terms of increasing the detection rate and pushing the sensitivity limit down to include such galaxies, however the limited FoV when observing at such high frequencies makes it difficult to use ALMA for studies of the large-scale structure traced out by molecular gas in galaxies. This article introduces a strategy for a systematic search for molecular gas during the EoR (z~7 and above), capitalizing on the fact that the J=1-0 transition of 12CO enters the upper bands of cm-wave instruments at high-z. The FoV advantage gained by observing at such frequencies, coupled with modern broadband correlators allows significant cosmological volumes to be probed on reasonable timescales. In this article we present an overview of our future observing programme which has been awarded 6,500 hours as one of the Large Survey Projects for MeerKAT, the forthcoming South African SKA pathfinder instrument. Its large FoV and correlator bandwidth, and high-sensitivity provide unprecedented survey speed for such work. An existing astrophysical simulation is coupled with instrumental considerations to demonstrate the feasibility of such observations and predict detection rates.Comment: 7 pages, 4 figures, to appear in the proceedings of "Astronomy with megastructures: Joint science with the E-ELT and SKA", 10-14 May 2010, Crete, Greece (Eds: Isobel Hook, Dimitra Rigopoulou, Steve Rawlings and Aris Karastergiou

Exploring positive pathways to care for members of the UK Armed Forces receiving treatment for PTSD: a qualitative study

Objective: To examine the factors which facilitate UK military personnel with post-traumatic stress disorder (PTSD) to engage in help-seeking behaviours. Methods: The study recruited active service personnel who were attending mental health services, employed a qualitative design, used semi-structured interview schedules to collect data, and explored these data using interpretative phenomenological analysis (IPA). Results: Five themes emerged about how participants were able to access help; having to reach a crisis point before accepting the need for help, overcoming feelings of shame, the importance of having an internal locus of control, finding a psychological explanation for their symptoms and having strong social support. Conclusions: This study reported that for military personnel who accessed mental health services, there were a number of factors that supported them to do so. In particular, factors that combated internal stigma, such as being supported to develop an internal locus of control, appeared to be critical in supporting military personnel to engage in help-seeking behaviour

The VLBA CANDELS GOODS-North Survey. I - Survey Design, Processing, Data Products, and Source Counts

The past decade has seen significant advances in wide-field cm-wave very long baseline interferometry (VLBI), which is timely given the wide-area, synoptic survey-driven strategy of major facilities across the electromagnetic spectrum. While wide-field VLBI poses significant post-processing challenges that can severely curtail its potential scientific yield, many developments in the km-scale connected-element interferometer sphere are directly applicable to addressing these. Here we present the design, processing, data products, and source counts from a deep (11 μJy beam-1), quasi-uniform sensitivity, contiguous wide-field (160 arcmin2) 1.6 GHz VLBI survey of the CANDELS GOODS-North field. This is one of the best-studied extragalactic fields at milli-arcsecond resolution and, therefore, is well-suited as a comparative study for our Tera-pixel VLBI image. The derived VLBI source counts show consistency with those measured in the COSMOS field, which broadly traces the AGN population detected in arcsecond-scale radio surveys. However, there is a distinctive flattening in the S1.4GHz ∼100-500 μJy flux density range, which suggests a transition in the population of compact faint radio sources, qualitatively consistent with the excess source counts at 15 GHz that is argued to be an unmodelled population of radio cores. This survey approach will assist in deriving robust VLBI source counts and broadening the discovery space for future wide-field VLBI surveys, including VLBI with the Square Kilometre Array, which will include new large field-of-view antennas on the African continent at ≥1000~km baselines. In addition, it may be useful in the design of both monitoring and/or rapidly triggered VLBI transient programmes

Team Objective Structured Bedside Assessment (TOSBA) as formative assessment in undergraduate Obstetrics and Gynaecology: a cohort study.

BACKGROUND: Team Objective Structured Bedside Assessment (TOSBA) is a learning approach in which a team of medical students undertake a set of structured clinical tasks with real patients in order to reach a diagnosis and formulate a management plan and receive immediate feedback on their performance from a facilitator. TOSBA was introduced as formative assessment to an 8-week undergraduate teaching programme in Obstetrics and Gynaecology (O\u26G) in 2013/14. Each student completed 5 TOSBA sessions during the rotation. The aim of the study was to evaluate TOSBA as a teaching method to provide formative assessment for medical students during their clinical rotation. The research questions were: Does TOSBA improve clinical, communication and/or reasoning skills? Does TOSBA provide quality feedback? METHODS: A prospective cohort study was conducted over a full academic year (2013/14). The study used 2 methods to evaluate TOSBA as a teaching method to provide formative assessment: (1) an online survey of TOSBA at the end of the rotation and (2) a comparison of the student performance in TOSBA with their performance in the final summative examination. RESULTS: During the 2013/14 academic year, 157 students completed the O\u26G programme and the final summative examination . Each student completed the required 5 TOSBA tasks. The response rate to the student survey was 68 % (n = 107/157). Students reported that TOSBA was a beneficial learning experience with a positive impact on clinical, communication and reasoning skills. Students rated the quality of feedback provided by TOSBA as high. Students identified the observation of the performance and feedback of other students within their TOSBA team as key features. High achieving students performed well in both TOSBA and summative assessments. The majority of students who performed poorly in TOSBA subsequently passed the summative assessments (n = 20/21, 95 %). Conversely, the majority of students who failed the summative assessments had satisfactory scores in TOSBA (n = 6/7, 86 %). CONCLUSIONS: TOSBA has a positive impact on the clinical, communication and reasoning skills of medical students through the provision of high-quality feedback. The use of structured pre-defined tasks, the observation of the performance and feedback of other students and the use of real patients are key elements of TOSBA. Avoiding student complacency and providing accurate feedback from TOSBA are on-going challenges