Discriminating between chronic fatigue syndrome and depression: a cognitive analysis

Background: chronic fatigue syndrome (CFS) and depression share a number of common symptoms and the majority of CFS patients meet lifetime criteria for depression. While cognitive factors seem key to the maintenance of CFS and depression, little is known about how the cognitive characteristics differ in the two conditions.Methods: fifty-three CFS patients were compared with 20 depressed patients and 38 healthy controls on perceptions of their health, illness attributions, self-esteem, cognitive distortions of general and somatic events, symptoms of distress and coping. A 6 month follow-up was also conducted to determine the stability of these factors and to investigate whether CFS-related cognitions predict ongoing disability and fatigue in this disorder.Results: between-group analyses confirmed that the depressed group was distinguished by low self-esteem, the propensity to make cognitive distortions across all situations, and to attribute their illness to psychological factors. In contrast, the CFS patients were characterized by low ratings of their current health status, a strong illness identity, external attributions for their illness, and distortions in thinking that were specific to somatic experiences. They were also more likely than depressed patients to cope with their illness by limiting stress and activity levels. These CFS-related cognitions and behaviours were associated with disability and fatigue 6 months later.Conclusions: CFS and depression can be distinguished by unique cognitive styles characteristic of each condition. The documented cognitive profile of the CFS patients provides support for the current cognitive behavioural models of the illness

Galactic dynamos with captured magnetic flux and an accretion flow

We examine the behaviour of an axisymmetric galactic dynamo model with a radial accretion flow in the disc. We also introduce a vertical magnetic flux through the galactic midplane, to simulate the presence of a large scale magnetic field trapped by the galaxy when forming. The trapped vertical flux is conserved and advected towards the disc centre by the radial flow. We confirm that accretion flows of magnitude several km/s through a significant part of the galactic disc can markedly inhibit dynamo action. Moreover, advection of the vertical flux in general results in mixed parity galactic fields. However, the effect is nonlinear and non-additive -- global magnetic field energies are usually significantly smaller that the sum of purely dynamo generated and purely advected field energies. For large inflow speeds, a form of `semi-dynamo' action may occur. We apply our results to the accumulation and redistribution, by a radial inflow, of a vertical magnetic flux captured by the Galactic disc. Taking representative values, it appears difficult to obtain mean vertical fields near the centre of the Milky Way that are much in excess of 10 microgauss, largely because the galactic dynamo and turbulent magnetic diffusion modify the external magnetic field before it can reach the disc centre.Comment: 18 pages, 12 figures, LaTE

Explaining adherence to self-care behaviours amongst adolescents with food allergy: a comparison of the health belief model and the common sense self-regulation model

OBJECTIVES: To identify explanations for adherence to self-care behaviours amongst adolescents with food allergy-induced anaphylaxis using two social cognition models: the health belief model (HBM) and the common sense self-regulation model (CS-SRM). DESIGN: Cross-sectional self-completion questionnaire study to gain initial evidence of the two models' feasibility/effectiveness in explaining adherence in an adolescent food-allergic population. METHODS: Participants aged 13-19 years with a diagnosis of severe food allergy and a prescription of an adrenaline auto-injector were recruited from hospital outpatients. Adherence to self-care behaviours was measured in addition to constructs from the HBM and CS-SRM. RESULTS: One hundred and eighty-eight food-allergic adolescents completed the questionnaire. The HBM, specifically the constructs perceived severity and barriers, accounted for 21% of the explained variance in adherence behaviours. CS-SRM constructs, illness identity, timeline cyclical beliefs and emotional representations explained 25% of the variance. CONCLUSIONS: Both models performed similarly in explaining adherence to self-care behaviours in adolescents with food allergy. Interventions designed to elicit personal barriers to adherence and to address perceptions of severity and the unpredictable nature of symptoms may be more effective in improving adherence to self-care behaviours than current interventions. STATEMENT OF CONTRIBUTION: What is already known on this subject? Patients' poor management of food allergy induced anaphylaxis is commonly attributed to lack of knowledge and ability in using the adrenaline auto-injector. Adherence to recommended preventive self-care behaviours, like allergen avoidance and carrying emergency medication, are rarely assessed. Social Cognition Models (SCMs) have been successfully applied to a number of adherence-related studies in disease conditions such as asthma and diabetes, but have not yet been applied to food allergy induced anaphylaxis. What does this study add? This is the first large-scale quantitative study of adherence behaviours in adolescents with food allergy. This is the first study to apply theoretical models to explain adherence in the adolescent food allergic population. This is the first application of both models to food allergy, and the first to compare the two models' measurement instruments

Newly diagnosed heart failure: change in quality of life, mood, and illness beliefs in the first 6 months after diagnosis

Objectives. This study sought to examine how patients’ mood and quality of life (QoL) change during the early high-risk period after a diagnosis of heart failure (HF) and to identify factors that may influence change. Design. A within-subjects, repeated-measures design was used. Assessments took place within 4 weeks of diagnosis and 6 months later. Methods. One hundred and sixty six patients with HF completed assessments of their mood, QoL, and beliefs about HF and its treatment. Correlation analysis was conducted between the variables and analysis of variance and t-tests were used to assess differences in categorical variables. To examine which variables predicted mood and QoL, hierarchical multiple regressions were conducted. Results. At follow-up, patients’ beliefs indicated a realization of the chronicity of their HF, however their beliefs about the consequences of having HF did not change and their satisfaction with their treatment remained high. QoL and anxiety improved significantly over time but there was no significant change in depressed mood. As would be expected, improvement in symptoms was a key factor in improved mood and QoL. Other significant explanatory variables included age, comorbid chronic obstructive pulmonary disease, depressed mood, patients’ beliefs about the consequences of their HF and their concerns about treatment. Conclusions. This study suggests that addressing patients’ mood and beliefs about their illness and its treatment may be additional ways of improving patient QoL in the early period after the diagnosis of HF

Molecular dynamic simulation of a homogeneous bcc -> hcp transition

We have performed molecular dynamic simulations of a Martensitic bcc->hcp transformation in a homogeneous system. The system evolves into three Martensitic variants, sharing a common nearest neighbor vector along a bcc direction, plus an fcc region. Nucleation occurs locally, followed by subsequent growth. We monitor the time-dependent scattering S(q,t) during the transformation, and find anomalous, Brillouin zone-dependent scattering similar to that observed experimentally in a number of systems above the transformation temperature. This scattering is shown to be related to the elastic strain associated with the transformation, and is not directly related to the phonon response.Comment: 11 pages plus 8 figures (GIF format); to appear in Phys. Rev.

Patients' treatment beliefs in low back pain: development and validation of a questionnaire in primary care

Choosing the most appropriate treatment for individual patients with low back pain (LBP) can be challenging, and clinical guidelines recommend taking into account patients' preferences. However, no tools exist to assess or compare patients' views about LBP treatments. We report the development and validation of the LBP Treatment Beliefs Questionnaire (LBP-TBQ) for use across different treatments in clinical practice and research. Using qualitative data we developed a pool of items assessing perceived credibility, effectiveness, concerns about and individual 'fit' of specific treatments. These items were included in a survey completed by 429 primary care patients with LBP, of whom 115 completed it again 1 to 2 weeks later. We performed psychometric analyses using non-parametric item response theory and classical test theory. The four subscales of the resulting 16-item LBP-TBQ showed good homogeneity (H=.46-.76), internal consistency (α =.73-.94), and stability (r=.63-.83), confirmed most convergent and discriminant validity hypotheses, and had acceptable structural validity for four guideline-recommended treatments: pain medication, exercise, manual therapy and acupuncture. Participants with stronger positive treatment beliefs were more likely to rank that treatment as their first choice, indicating good criterion validity (t values=3.11-9.80, all p<.01, except pain medication effectiveness beliefs, t(339)=1.35; p=.18). A short 4-item version also displayed good homogeneity (H=.43-.66), internal consistency (α=.70-.86), and stability (r=.82-.85), and was significantly related to treatment choice (t values=4.33-9.25, all p<.01). The LBP-TBQ can be used to assess treatment beliefs in primary care patients with LBP and to investigate the effects of treatment beliefs on treatment uptake and adherence.This is an open access article distributed under the terms of the Creative Commons Attribution-Noncommercial No Derivatives 3.0 License, which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially

266 E+A Galaxies Selected from the Sloan Digital Sky Survey Data Release 2: The Origin of E+A Galaxies

E+A galaxies are characterized as a galaxy with strong Balmer absorption lines but without any [OII] nor H$\alpha$ emission lines. The existence of strong Balmer absorption lines indicates that E+A galaxies have experienced starburst within recent one Gyr. However, the lack of [OII] and H$\alpha$ emission lines indicates that E+A galaxies do not have any on-going star formation. Therefore, E+A galaxies are interpreted as a post-starburst galaxy. For many years, however, it has been a mystery why E+A galaxies started starburst and why they quenched the star formation abruptly. Using one of the largest samples of 266 E+A galaxies carefully selected from the Sloan Digital Sky Survey Data Release 2, we have investigated the environment of E+A galaxies from 50 kpc to 8 Mpc scale, i.e., from a typical distance to satellite galaxies to the scale of large scale structures. We found that E+A galaxies have excess of local galaxy density only at a scale of $<100$ kpc (with a two $\sigma$ significance), but not at the cluster scale ($\sim$1.5 Mpc) nor in the scale of large scale structure ($\sim$8 Mpc). These results indicate that E+A galaxies are not created by the physical mechanisms associated with galaxy clusters or the large scale structure, but are likely to be created by the dynamical interaction with closely accompanying galaxies at a $<$100 kpc scale. The claim is also supported by the morphology of E+A galaxies. We have found that almost all E+A galaxies have a bright compact core, and that $\sim$30% of E+A galaxies have dynamically disturbed signatures or the tidal tails, being quite suggestive of morphological appearance of merger/interaction remnants.Comment: 2005, MNRAS, 357, 93