An internet survey of psychiatrists who have a particular interest in cognitive behavioural therapy: what is the place for the cognitive behavioural model in their role as a psychiatrist?

A survey of psychiatrists with a special interest in CBT was conducted by email correspondence to answer two main questions: ‘What are the uses and the usefulness of the cognitive behavioural model within the day-to-day practice of psychiatrists?’ and ‘What are the most important roles of the consultant medical psychotherapist who has specialized in CBT?’ Despite the constraints of a low response rate the results still reflected the views of 46 psychiatrists who were particularly experienced in the area of CBT. They reported that the cognitive behavioural model was useful in general psychiatric settings, in particular in the engagement of patients, improving client's insight, adherence to medications, and for trainee supervision. The responders reaffirmed previously held views about the role of the consultant medical psychotherapist (CBT), in particular the roles of the assessment and management of complex cases, of taking responsibility for patients with a combination of medical and psychological issues and of teaching CBT to psychiatrists and other mental health professionals. The challenges of translating CBT competencies into generic non-CBT psychiatric settings are discussed, with the important potential role of the medical psychotherapist in this respect. The key skill of formulating cases in secondary care is emphasized

Prognostic significance of early short-term measurements of heart rate variability following acute myocardial infarction.

This study of 164 subjects demonstrates that short-term (5-minute) recordings of heart rate variability, performed within 48 hours of admission, identify those who survive acute myocardial infarction but have an adverse prognosis

Assessing multi-version systems through fault Injection

Multi-version design (MVD) has been proposed as a method for increasing the dependability of critical systems beyond current levels. However, a major obstacle to large-scale commercial usage of this approach is the lack of quantitative characterizations available. Fault injection is used to help seek an answer this problem. Fault injection is a phrase covering a variety of testing techniques that can be applied to both hardware and software, all of which involve the deliberate insertion of faults into an operational system to determine its response. This approach has the potential for yielding highly useful metrics with regard to MVD systems, as well as giving developers a greater insight into the behaviour of each channel within the system, k this research, an automatic fault injection system for multi-version systems called FITMVS is developed. A multi-version system is then, tested using this system, and the results analysed. It is concluded that this approach can yield several extremely useful metrics, such as metrics related to channel sensitivity, channel sensitivity to common-mode error, program' scope sensitivity, program scope sensitivity to common-mode error, error frequency distribution and common-mode error frequency distribution. In addition to this, the analysis of the multi-version system tested indicates that the system has an extremely low probability of experiencing common-mode error, although several key points in channel code are identified as having higher sensitivity to faults than others

Cognitive behaviour therapy for psychosis in high secure services: An exploratory hermeneutic review of the international literature

Background: Mainstream psychological interventions may need adaptation in High Secure (HS) healthcare contexts to enable better recovery, safeguard the public and offer economic value. One specific psychological intervention, cognitive behavioural therapy for psychosis (CBTp), has an already proven efficacy in aiding recovery in non-forensic populations, yet its impact in HS settings has received considerably less research attention. Aims: This exploratory review catalogues CBTp approaches used in HS hospitals and appraises impact through the inclusion of both fugitive literature and peer reviewed research. Method: A pragmatic approach was utilized through an iterative literature search strategy and hermeneutic source analysis of the identified studies. Results: Fourteen studies were identified from HS contexts from within the UK and internationally. These included group, individual therapy and CBTp linked milieus. Conclusions: CBTp is an active component of treatment in HS contexts. Some modes of delivery seem to have greater levels of efficacy with more typical HS patients. The literature indicates key differences between HS and non-HS applied CBTp. Continued application and evaluation of CBTp in HS conditions is warranted

Ambient seismic noise tomography of Canada and adjacent regions: Part I. Crustal structures

This paper presents the first continental-scale study of the crust and upper mantle shear velocity (V_s) structure of Canada and adjacent regions using ambient noise tomography. Continuous waveform data recorded between 2003 and 2009 with 788 broadband seismograph stations in Canada and adjacent regions were used in the analysis. The higher primary frequency band of the ambient noise provides better resolution of crustal structures than previous tomographic models based on earthquake waveforms. Prominent low velocity anomalies are observed at shallow depths (<20 km) beneath the Gulf of St. Lawrence in east Canada, the sedimentary basins of west Canada, and the Cordillera. In contrast, the Canadian Shield exhibits high crustal velocities. We characterize the crust-mantle transition in terms of not only its depth and velocity but also its sharpness, defined by its thickness and the amount of velocity increase. Considerable variations in the physical properties of the crust-mantle transition are observed across Canada. Positive correlations between the crustal thickness, Moho velocity, and the thickness of the transition are evident throughout most of the craton except near Hudson Bay where the uppermost mantle V_s is relatively low. Prominent vertical V_s gradients are observed in the midcrust beneath the Cordillera and beneath most of the Canadian Shield. The midcrust velocity contrast beneath the Cordillera may correspond to a detachment zone associated with high temperatures immediately beneath, whereas the large midcrust velocity gradient beneath the Canadian Shield probably represents an ancient rheological boundary between the upper and lower crust

A Feasibility Study of a Novel Work-focused Relational Group CBT Treatment Programme for Moderate to Severe Recurrent Depression.

No current psychotherapeutic intervention is designed to enhance job retention in employees with moderate-severe recurrent depression. We hypothesized that interdisciplinary, work-focused psychotherapy would have the triple benefits of alleviating depression, improving interpersonal difficulties, and enhancing job retention. To test the feasibility of a new Work-focused Relational Group-CBT Treatment Programme for moderate-severe depression. The new programme was based on a theoretical integration of occupational stress, psychological, social/interpersonal, and bio-medical theories and consisted of (i) 1:1 psychotherapist sessions; (ii) a work-focused, twelve-week group CBT programme; and (iii) optional 1:1 sessions with an occupational therapist. Depression, coping/self-efficacy, health-related quality of life (HRQoL), interpersonal difficulty, and work/social functioning outcomes were assessed before and after group therapy using validated instruments. Intervention delivery, therapeutic alliance, client satisfaction, and programme cost were assessed. While there was no statistically significant change in HAM-D depression scores after therapy (n=5; p=0.313), there was a significant decrease in BDI-II depression scores after therapy (n=8; -20.0 median change, p=0.016; 6/8 responses, 7/8 minimal clinically important differences, 2 remissions). There were significant reductions in clinically relevant psychological distress, coping self-efficacy, HRQoL, and interpersonal difficulties after therapy. All clients in work at the start of therapy remained in work at the end of therapy. The intervention was safe, had 100% retention, and clients were satisfied with their treatment. The Work-focused Relational Group-CBT Treatment Programme showed promising immediate positive outcomes in terms of depressive symptoms, interpersonal difficulties, and job retention that warrant further exploration in a longer-term definitive study.N

Aftershock Sequences Modeled with 3-D Stress Heterogeneity and Rate-State Seismicity Equations: Implications for Crustal Stress Estimation

In this paper, we present a model for studying aftershock sequences that integrates Coulomb static stress change analysis, seismicity equations based on rate-state friction nucleation of earthquakes, slip of geometrically complex faults, and fractal-like, spatially heterogeneous models of crustal stress. In addition to modeling instantaneous aftershock seismicity rate patterns with initial clustering on the Coulomb stress increase areas and an approximately 1/t diffusion back to the pre-mainshock background seismicity, the simulations capture previously unmodeled effects. These include production of a significant number of aftershocks in the traditional Coulomb stress shadow zones and temporal changes in aftershock focal mechanism statistics. The occurrence of aftershock stress shadow zones arises from two sources. The first source is spatially heterogeneous initial crustal stress, and the second is slip on geometrically rough faults, which produces localized positive Coulomb stress changes within the traditional stress shadow zones. Temporal changes in simulated aftershock focal mechanisms result in inferred stress rotations that greatly exceed the true stress rotations due to the main shock, even for a moderately strong crust (mean stress 50 MPa) when stress is spatially heterogeneous. This arises from biased sampling of the crustal stress by the synthetic aftershocks due to the non-linear dependence of seismicity rates on stress changes. The model indicates that one cannot use focal mechanism inversion rotations to conclusively demonstrate low crustal strength (≤10 MPa); therefore, studies of crustal strength following a stress perturbation may significantly underestimate the mean crustal stress state for regions with spatially heterogeneous stress

Extension and stress during continental breakup: seismic anisotropy of the crust in Northern Afar

Studies that attempt to simulate continental rifting and subsequent breakup require detailed knowledge of crustal stresses, however observational constraints from continental rifts are lacking. In addition, a knowledge of the stress field around active volcanoes can be used to detect sub-surface changes to the volcanic system. Here we use shear wave splitting to measure the seismic anisotropy of the crust in Northern Afar, a region of active, magma-rich continental breakup. We combine shear wave splitting tomography with modelling of gravitational and magmatic induced stresses to propose a model for crustal stress and strain across the rift. Results show that at the Ethiopian Plateau, seismic anisotropy is consistently oriented N–S. Seismic anisotropy within the rift is generally oriented NNW–SSE, with the exception of regions north and south of the Danakil Depression where seismic anisotropy is rift-perpendicular. These results suggest that the crust at the rift axis is characterized by rift-aligned structures and melt inclusions, consistent with a focusing of tectonic extension at the rift axis. In contrast, we show that at regions within the rift where extension rate is minimal the seismic anisotropy is best explained by the gravitationally induced stress field originating from variations in crustal thickness. Seismic anisotropy away from the rift is controlled by a combination of inherited crustal structures and gravitationally induced extension whereas at the Dabbahu region we show that the stress field changes orientation in response to magmatic intrusions. Our proposed model provides a benchmark of crustal stress in Northern Afar which will aid the monitoring of volcanic hazard. In addition we show that gravitational forces play a key role in measurements of seismic anisotropy, and must be considered in future studies. We demonstrate that during the final stages of continental rifting the stress field at the rift axis is primarily controlled by tectonic extension, but that gravitational forces and magmatic intrusions can play a key role in the orientation of the stress field

Global crustal stress pattern based on the world stress map database release 2008

The World Stress Map (WSM) project is a global compilation of information on the contemporary crustal stress field from a wide range of stress indicators. The WSM database release 2008 contains 21,750 stress data records that are quality-ranked using an updated and refined quality-ranking scheme. Almost 17,000 of these data records have A–C quality and are considered to record the orientation of maximum horizontal compressional stress SH to within ±25°. As this is almost a triplication of data records compared with the first WSM database release in 1992, we reinvestigate the spatial wave-length of the stress patterns with a statistical analysis on a global 0.5° grid. The resulting smoothed global stress map displays both; the mean SH orientation that follows from the maximum smoothing radius for which the standard deviation is 2000 km) exist for example in North America and NE Asia. These have been used in earlier analyses to conclude that the global stress pattern is primarily controlled by plate boundary forces that are transmitted into the intraplate region. However, our analysis reveals that rather short wave-length of the stress pattern <200 km are quite frequent too, particularly in western Europe, Alaska and the Aleutians, the southern Rocky Mountains, Basin and Range province, Scandinavia, Caucasus, most of the Himalayas and Indonesia. This implies that local stress sources such as density contrasts and active fault systems in some areas have high impact in comparison to plate boundary forces and control the regional stress pattern