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

'I have to live with the decisions I make': laying a foundation for decision making for children with life-limiting conditions and life-threatening illnesses.

The relationship between parents and clinician is critical to the care and treatment of children with life-limiting conditions (LLCs) and life-threatening illnesses (LTIs). This relationship is built and maintained largely in consultations. In this article we lay out factors that bear on the success of clinical consultations and the maintenance of the essential clinician-parent relationship at progression or deterioration of LLCs or LTIs. We suggest an approach to engaging parents in conversations about care and treatment that recognises and appreciates the dilemmas which clinicians and parents face and in so doing provides a way for everyone to live with the decisions that are made. A close analysis of a consultation at progression and excerpts of encounters among parents, clinician and researcher are used to illustrate our approach to research, analysis and development of recommendations for clinical practice

The Electron Energy Distribution in the Hotspots of Cygnus A: Filling the Gap with the Spitzer Space Telescope

Here we present Spitzer Space Telescope imaging of Cyg A with the Infrared Array Camera, resulting in the detection of the high-energy tails or cut-offs in the synchrotron spectra for all four hotspots of this archetype radio galaxy. When combined with the other data collected from the literature, our observations allow for detailed modeling of the broad-band emission for the brightest spots A and D. We confirm that the X-ray flux detected previously from these features is consistent with the synchrotron self-Compton radiation for the magnetic field intensity 170 muG in spot A, and 270 muG in spot D. We also find that the energy density of the emitting electrons is most likely larger by a factor of a few than the energy density of the hotspots' magnetic field. We construct energy spectra of the radiating ultrarelativistic electrons. We find that for both hotspots A and D these spectra are consistent with a broken power-law extending from at least 100 MeV up to 100 GeV, and that the spectral break corresponds almost exactly to the proton rest energy of 1 GeV. We argue that the shape of the electron continuum reflects two different regimes of the electron acceleration process at mildly relativistic shocks, rather than resulting from radiative cooling and/or absorption effects. In this picture the protons' inertia defines the critical energy for the hotspot electrons above which Fermi-type acceleration processes may play a major role, but below which the operating acceleration mechanism has to be of a different type. At energies >100 GeV, the electron spectra cut-off/steepen again, most likely as a result of spectral aging due to radiative loss effects. We discuss several implications of the presented analysis for the physics of extragalactic jets.Comment: 29 pages, 8 figures and 2 tables included. Accepted for publication in Ap

A Chandra X-ray Study of Cygnus A - II. The Nucleus

We report Chandra ACIS and quasi-simultaneous RXTE observations of the nearby, powerful radio galaxy Cygnus A, with the present paper focusing on the properties of the active nucleus. In the Chandra observation, the hard (> a few keV) X-ray emission is spatially unresolved with a size \approxlt 1 arcsec (1.5 kpc, H_0 = 50 km s^-1 Mpc^-1) and coincides with the radio and near infrared nuclei. In contrast, the soft (< 2 keV) emission exhibits a bi-polar nebulosity that aligns with the optical bi-polar continuum and emission-line structures and approximately with the radio jet. In particular, the soft X-ray emission corresponds very well with the [O III] \lambda 5007 and H\alpha + [N II] \lambda\lambda 6548, 6583 nebulosity imaged with HST. At the location of the nucleus there is only weak soft X-ray emission, an effect that may be intrinsic or result from a dust lane that crosses the nucleus perpendicular to the source axis. The spectra of the various X-ray components have been obtained by simultaneous fits to the 6 detectors. The compact nucleus is detected to 100 keV and is well described by a heavily absorbed power law spectrum with \Gamma_h = 1.52^{+0.12}_{-0.12} (similar to other narrow line radio galaxies) and equivalent hydrogen column N_H (nuc) = 2.0^{+0.1}_{-0.2} \times 10^{23} cm^-2. (Abstract truncated).Comment: To be published in the Astrophysical Journal, v564 January 1, 2002 issue; 34 pages, 11 figures (1 color

SANEPIC: A Map-Making Method for Timestream Data From Large Arrays

We describe a map-making method which we have developed for the Balloon-borne Large Aperture Submillimeter Telescope (BLAST) experiment, but which should have general application to data from other submillimeter arrays. Our method uses a Maximum Likelihood based approach, with several approximations, which allows images to be constructed using large amounts of data with fairly modest computer memory and processing requirements. This new approach, Signal And Noise Estimation Procedure Including Correlations (SANEPIC), builds upon several previous methods, but focuses specifically on the regime where there is a large number of detectors sampling the same map of the sky, and explicitly allowing for the the possibility of strong correlations between the detector timestreams. We provide real and simulated examples of how well this method performs compared with more simplistic map-makers based on filtering. We discuss two separate implementations of SANEPIC: a brute-force approach, in which the inverse pixel-pixel covariance matrix is computed; and an iterative approach, which is much more efficient for large maps. SANEPIC has been successfully used to produce maps using data from the 2005 BLAST flight.Comment: 27 Pages, 15 figures; Submitted to the Astrophysical Journal; related results available at http://blastexperiment.info/ [the BLAST Webpage

Melanoma in congenital melanocytic naevi

Congenital melanocytic naevi (CMN) are a known risk factor for melanoma, with the greatest risk currently thought to be in childhood. There has been controversy over the years about the incidence, and therefore over clinical management of CMN, due partly to the difficulties of histological diagnosis and partly to publishing bias towards cases of malignancy. Large cohort studies have demonstrated that risk in childhood is related to the severity of the congenital phenotype, not only cutaneous but neuroradiological. New understanding of the genetics of CMN offers the possibility of improvement in diagnosis of melanoma, identification of those at highest risk, and new treatment options. We review the world literature and our centre's experience over the last 25 years, including the molecular characteristics of melanoma in these patients and new melanoma incidence and outcome data from our prospective cohort. Management strategies are proposed for presentation of suspected melanoma of the skin and the CNS in patients with CMN, including use of oral MEK inhibitors in NRAS-mutated tumours. This article is protected by copyright. All rights reserved

An Examination of the Association Between Student-Teacher Interactions and Academic Self-Concept Among African American Male High School Students

Students generally spend more than ten years interacting with teachers in a classroom and thus, such interactions can have a positive or negative impact on students’ academic self-concept and educational goals (Rosenthal, Folse, Allerman, Boudreaux, Soper, & Von Bergen, 2000). The purpose of this study is to determine whether there is a significant relationship between student-teacher interactions and academic self-concept. Participants in the study include African American male high school students in an urban school district. The independent variable is the student-teacher interactions, as measured by the Student-Professor Interaction Scale (Cokley et al., 2004). The dependent variable is the students’ academic-self-concept, which is measured by the Academic Self-Concept Scale (Reynolds, Ramirez, Magrina, & Allen, 1980). The data was analyzed by using Pearson’s correlation and hierarchical multiple regression to determine if there was a statistically significant relationship between the two variables. Findings, study limitations, and future research directions are also discussed

The origins of X-ray emission from the hotspots of FRII radio sources

We use new and archival Chandra data to investigate the X-ray emission from a large sample of compact hotspots of FRII radio galaxies and quasars from the 3C catalogue. We find that only the most luminous hotspots tend to be in good agreement with the predictions of a synchrotron self-Compton model with equipartition magnetic fields. At low hotspot luminosities inverse-Compton predictions are routinely exceeded by several orders of magnitude, but this is never seen in more luminous hotspots. We argue that an additional synchrotron component of the X-ray emission is present in low-luminosity hotspots, and that the hotspot luminosity controls the ability of a given hotspot to produce synchrotron X-rays, probably by determining the high-energy cutoff of the electron energy spectrum. It remains plausible that all hotspots are close to the equipartition condition.Comment: 49 pages, 16 figures. ApJ accepted. Revised version fixes a typo in one of the Tables and corrects a statement about 3C27

Wide-field global VLBI and MERLIN combined monitoring of supernova remnants in M82

From a combination of MERLIN (Multi-Element Radio-Linked Interferometer Network) and global VLBI (Very Long Baseline Interferometry) observations of the starburst galaxy M82, images of 36 discrete sources at resolutions ranging from ~3 to ~80 mas at 1.7 GHz are presented. Of these 36 sources, 32 are identified as supernova remnants, 2 are HII regions, and 3 remain unclassified. Sizes, flux densities and radio brightnesses are given for all of the detected sources. Additionally, global VLBI only data from this project are used to image four of the most compact radio sources. These data provide a fifth epoch of VLBI observations of these sources, covering a 19-yr time-line. In particular, the continued expansion of one of the youngest supernova remnants, 43.31+59.3 is discussed. The deceleration parameter is a power-law index used to represent the time evolution of the size of a supernova remnant. For the source 43.31+59.3, a lower limit to the deceleration parameter is calculated to be 0.53+/-0.06, based on a lower limit of the age of this source.Comment: 31 pages, 12 figures, 7 table

WHAT DO TEACHERS THINK ABOUT EDUCATIONAL PSYCHOLOGY? DEVELOPING AND VALIDATING THE EDUCATIONAL PSYCHOLOGY PRACTITIONER SCALE

The purpose of this study was to develop and validate the Educational Psychology Practitioner Scale (EPPS), which was designed to (a) assess the practices, training, and skills of educational psychologists and (b) determine their utility among K-12 schools classroom teachers. Study participants included 161 K-12 teachers across 21 states within the United States. An exploratory factor analysis yielded a 25-item, unidimensional scale. Correlating the EPPS with the Teacher Sense of Efficacy Scale (Tschannen-Moran & Woolfolk Hoy, 2001) and the Job Satisfaction Scale (Warner, 1973) provided discriminant validity for the scale. Study limitations and future research directions are discussed