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Functional cognitive disorder is an increasingly recognised subtype of functional neurological disorder for which treatment options are currently limited. We have developed a brief online group acceptance and commitment therapy (ACT)-based intervention.
Aims
To assess the feasibility of conducting a randomised controlled trial of this intervention versus treatment as usual (TAU).
Method
The study was a parallel-group, single-blind randomised controlled trial, with participants recruited from cognitive neurology, neuropsychiatry and memory clinics in London. Participants were randomised into two groups: ACT + TAU or TAU alone. Feasibility was assessed on the basis of recruitment and retention rates, the acceptability of the intervention, and signal of efficacy on the primary outcome measure (Acceptance and Action Questionnaire II (AAQ-II)) score, although the study was not powered to demonstrate this statistically. Outcome measures were collected at baseline and at 2, 4 and 6 months post-intervention, including assessments of quality of life, memory, anxiety, depression and healthcare use.
Results
We randomised 44 participants, with a participation rate of 51.1% (95% CI 40.8–61.5%); 36% of referred participants declined involvement, but retention was high, with 81.8% of ACT participants attending at least four sessions, and 64.3% of ACT participants reported being ‘satisfied’ or ‘very satisfied’ compared with 0% in the TAU group. Psychological flexibility as measured using the AAQ-II showed a trend towards modest improvement in the ACT group at 6 months. Other measures (quality of life, mood, memory satisfaction) also demonstrated small to modest positive trends.
Conclusions
It has proven feasible to conduct a randomised controlled trial of ACT versus TAU.
The consent process for research studies can be burdensome for potential participants due to complex information and lengthy consent forms. This pragmatic study aimed to improve the consent experience and evaluate its impact on participant decision making, study knowledge, and satisfaction with the In Our DNA SC program, a population-based genomic screening initiative. We compared two consent procedures: standard consent (SC) involving a PDF document and enhanced consent (EC) incorporating a pictograph and true or false questions. Decision-making control, study knowledge, satisfaction, and time to consent were assessed. We analyzed data for 109 individuals who completed the SC and 96 who completed the EC. Results indicated strong decision-making control and high levels of knowledge and satisfaction in both groups. While no significant differences were found between the two groups, the EC experience took longer for participants to complete. Future modifications include incorporating video modules and launching a Spanish version of the consent experience. Overall, this study contributes to the growing literature on consent improvements and highlights the need to assess salient components and explore participant preferences for receiving consent information.
Crystal growth theory was applied to describe edge sites of phyllosilicates. Three face configurations were found to exist. One face has one tetrahedral site per tetrahedral sheet and two octahedral one-coordinated sites per crystallographic area ac sin β, where a and c are layer dimensions and β is the angle between them. The other two faces are similar except that they have one less octahedral site which is replaced by one SiIV-O-AlVI site in this same ac sin β area. A transfer of bonding energy from the remaining octahedral site to the SiIV-O-AlVI site is believed to neutralize all edge charge on faces containing these latter sites at normally encountered pHs (pH 3–9). A similar charge rearrangement along the edges results in an apparent decrease in the permanent charge of the mineral with an increase in edge area.
On the basis of such an analysis, lath-shaped illite can be described as a very fine grained dioctahedral mica in which the apparent deficient occupancy of the octahedral sheet, presence of excess water, and measurable cation-exchange capacity may in part be the result of a large ratio of edge area to total volume, with no other chemical or structural change in the mica layers. The increasing importance of edge charge relative to layer charge produces erroneous formulae for 2:1 phyllosilicates in very fine grained samples containing fewer than 2 of 3 octahedral sites occupied by cations, on the basis of a 22-charge half cell.
Many of the presently oxidized Georgia kaolins probably existed originally in the reduced (gray) state. For that reason, the distribution of iron sulfides in presently gray kaolins may elucidate features observed in oxidized kaolins. An understanding of the nature of gray kaolins may also aid in the development of processing strategies for the exploitation of these abundant resources. The size, morphology, and degree of crystallite bonding of iron sulfides (pyrite and marcasite) in three gray kaolin cores from the Macon, Georgia kaolin district were examined by X-ray powder diffraction, X-ray fluorescence, scanning electron microscopy, and other physical and chemical methods. Pyrite and marcasite were identified as dominantly gravel- and sand-size equant crystals and crystal aggregates, rather than as framboids. Pyrite crystals commonly showed rough octahedral faces, which extended over minor cube faces. Locally, spiral growth dislocations were also observed. Marcasite was found in radiating, prismatic, and tabular crystals. In general, the marcasite crystal aggregates were much more fragile than those of pyrite. The dominance of octahedral crystal shapes and textures of the pyrite suggest inorganic precipitation from solutions supersaturated with respect to octahedral crystal faces.
One Tertiary and two Cretaceous gray kaolin sites in Georgia were examined using X-ray radiography of core sections to determine the processes of formation of the deposits. The Tertiary kaolin was oxidized in the upper 3 m of the deposit and reduced below that point. The two Cretaceous kaolins were reduced from the top of the deposit to an abrupt boundary with oxidized red kaolin below. Radiography of the first Cretaceous core revealed thin laminar bedding in the gray kaolin and in the underlying red kaolin. The laminae continue without interruption across the gray kaolin/red kaolin boundary. The laminae were not visible in the gray kaolin except in radiographs. Sedimentary bedding was not observed visually or radiographically at the Tertiary site nor in sections of the core from the second Cretaceous site where kaolinite was recrystallized to large vermiforms. The original sedimentary structure in the first Cretaceous kaolin was preserved possibly due to the inhibition of kaolinite recrystallization by a higher organic matter content. Recrystallization of kaolinite and iron compounds may have destroyed sedimentary structures in part or all of the other two kaolin cores. It is hypothesized that the first Cretaceous physical and biological mixing. The same hypothesis may apply to the other two kaolins but recrystallization after deposition has destroyed sedimentary structures.
The sorption of the uranyl oxo-cation (UO22+)at different types of binding sites on layer silicate mineral surfaces was investigated. Well-characterized samples of vermiculite and hydrobiotite were exposed to aqueous uranyl under conditions designed to promote surface sorption either at fixed charge ionexchange sites or at amphoteric surface hydroxyl sites. The local structure of uranium in the sorption samples was directly measured using uranium L3-edge extended X-ray absorption fine structure (EXAFS). Polarized L1- and L3-edge X-ray absorption near-edge structure (XANES) measurements were used to characterize the orientation of uranyl groups in layered samples. X-ray diffraction (XRD) measurements of interlayer spacings were used to assess the effects of ion-exchange and dehydration upon the mineral structure. The most significant findings are: (1) Under conditions which greatly favor ion-exchange sorption mechanisms, uranyl retains a symmetric local structure suggestive of an outer-sphere complex, with a preferred orientation of the uranyl axis parallel to the mineral layers; (2) Upon dehydration, the ionexchange complexes adopt a less symmetric structure, consistent with an inner-sphere complex, with less pronounced orientation of the uranyl axis; and (3) For conditions which favor sorption at surface hydroxyl sites, uranyl has a highly distorted equatorial shell, indicative of stronger equatorial ligation, and the detection of a neighboring U atom suggests the formation of surface precipitates and/or oligomeric complexes.
Non-ionic surfactants Brij 56 and Igepal CO 720, containing hydrophilic poly(ethylene oxide) (PEO) segments, expanded smectite from 1.5 nm to 1.7 nm at room temperature. The surfactant-smectite composites had larger layer spacings than Ca-smectite after heat treatment. The surfactant-smectite composites were solvated and expanded to 1.8–1.9 nm by polar solvents, glycerol and water, but were not affected by the non-polar or weakly polar solvents, toluene, hexane or octanol. The hydrophilic PEO segments of non-ionic surfactants would logically access the interlayer spaces of smectite whereas the hydrophobic segments extend away from the mineral. The molecular structure and solvation properties suggest that the surfactant molecules are probably concentrated in the margin area of the interlayer galleries forming an annular ring structure between two neighboring silicate sheets. Only two layers or less of the surfactants could access the interlayer galleries of smectite and layer spacings did not exceed 1.8 nm even where excess surfactant was introduced into the composites. The layer spacings of the surfactant-smectite composites were well preserved during water or electrolyte solution washings, indicating stability of most non-ionic surfactant molecules in the interlayer galleries even though ∼30% of the adsorbed Igepal CO 720 was desorbed by exhaustive washing. The non-ionic surfactant treatment preserved >80% of the CEC of the smectite. The interlayer cations of the resulting surfactant-smectite were exchangeable as in the untreated smectite. Therefore, the non-ionic surfactant-smectite was much more efficient at removing heavy metal ions than activated carbon or cationic surfactant-treated smectite. The surfactant-smectite composites effectively removed aromatic chlorophenols from a pH 4.9 acetate buffer solution while untreated smectite did not adsorb these molecules. The enhanced adsorption of the aromatic compounds is attributed to the aliphatic segments of the two surfactants.
We identify a set of essential recent advances in climate change research with high policy relevance, across natural and social sciences: (1) looming inevitability and implications of overshooting the 1.5°C warming limit, (2) urgent need for a rapid and managed fossil fuel phase-out, (3) challenges for scaling carbon dioxide removal, (4) uncertainties regarding the future contribution of natural carbon sinks, (5) intertwinedness of the crises of biodiversity loss and climate change, (6) compound events, (7) mountain glacier loss, (8) human immobility in the face of climate risks, (9) adaptation justice, and (10) just transitions in food systems.
Technical summary
The Intergovernmental Panel on Climate Change Assessment Reports provides the scientific foundation for international climate negotiations and constitutes an unmatched resource for researchers. However, the assessment cycles take multiple years. As a contribution to cross- and interdisciplinary understanding of climate change across diverse research communities, we have streamlined an annual process to identify and synthesize significant research advances. We collected input from experts on various fields using an online questionnaire and prioritized a set of 10 key research insights with high policy relevance. This year, we focus on: (1) the looming overshoot of the 1.5°C warming limit, (2) the urgency of fossil fuel phase-out, (3) challenges to scale-up carbon dioxide removal, (4) uncertainties regarding future natural carbon sinks, (5) the need for joint governance of biodiversity loss and climate change, (6) advances in understanding compound events, (7) accelerated mountain glacier loss, (8) human immobility amidst climate risks, (9) adaptation justice, and (10) just transitions in food systems. We present a succinct account of these insights, reflect on their policy implications, and offer an integrated set of policy-relevant messages. This science synthesis and science communication effort is also the basis for a policy report contributing to elevate climate science every year in time for the United Nations Climate Change Conference.
Social media summary
We highlight recent and policy-relevant advances in climate change research – with input from more than 200 experts.
Human infection with antimicrobial-resistant Campylobacter species is an important public health concern due to the potentially increased severity of illness and risk of death. Our objective was to synthesise the knowledge of factors associated with human infections with antimicrobial-resistant strains of Campylobacter. This scoping review followed systematic methods, including a protocol developed a priori. Comprehensive literature searches were developed in consultation with a research librarian and performed in five primary and three grey literature databases. Criteria for inclusion were analytical and English-language publications investigating human infections with an antimicrobial-resistant (macrolides, tetracyclines, fluoroquinolones, and/or quinolones) Campylobacter that reported factors potentially linked with the infection. The primary and secondary screening were completed by two independent reviewers using Distiller SR®. The search identified 8,527 unique articles and included 27 articles in the review. Factors were broadly categorised into animal contact, prior antimicrobial use, participant characteristics, food consumption and handling, travel, underlying health conditions, and water consumption/exposure. Important factors linked to an increased risk of infection with a fluoroquinolone-resistant strain included foreign travel and prior antimicrobial use. Identifying consistent risk factors was challenging due to the heterogeneity of results, inconsistent analysis, and the lack of data in low- and middle-income countries, highlighting the need for future research.
We summarize what we assess as the past year's most important findings within climate change research: limits to adaptation, vulnerability hotspots, new threats coming from the climate–health nexus, climate (im)mobility and security, sustainable practices for land use and finance, losses and damages, inclusive societal climate decisions and ways to overcome structural barriers to accelerate mitigation and limit global warming to below 2°C.
Technical summary
We synthesize 10 topics within climate research where there have been significant advances or emerging scientific consensus since January 2021. The selection of these insights was based on input from an international open call with broad disciplinary scope. Findings concern: (1) new aspects of soft and hard limits to adaptation; (2) the emergence of regional vulnerability hotspots from climate impacts and human vulnerability; (3) new threats on the climate–health horizon – some involving plants and animals; (4) climate (im)mobility and the need for anticipatory action; (5) security and climate; (6) sustainable land management as a prerequisite to land-based solutions; (7) sustainable finance practices in the private sector and the need for political guidance; (8) the urgent planetary imperative for addressing losses and damages; (9) inclusive societal choices for climate-resilient development and (10) how to overcome barriers to accelerate mitigation and limit global warming to below 2°C.
Social media summary
Science has evidence on barriers to mitigation and how to overcome them to avoid limits to adaptation across multiple fields.
Nitrogen fixation from pasture legumes is a fundamental process that contributes to the profitability and sustainability of dryland agricultural systems. The aim of this research was to determine whether well-managed pastures, based on aerial-seeding pasture legumes, could partially or wholly meet the nitrogen (N) requirements of subsequent grain crops in an annual rotation. Fifteen experiments were conducted in Western Australia with wheat, barley or canola crops grown in a rotation that included the pasture legume species French serradella (Ornithopus sativus), biserrula (Biserrula pelecinus), bladder clover (Trifolium spumosum), annual medics (Medicago spp.) and the non-aerial seeded subterranean clover (Trifolium subterraneum). After the pasture phase, five rates of inorganic N fertilizer (Urea, applied at 0, 23, 46, 69 and 92 kg/ha) were applied to subsequent cereal and oil seed crops. The yields of wheat grown after serradella, biserrula and bladder clover, without the use of applied N fertilizer, were consistent with the target yields for growing conditions of the trials (2.3 to 5.4 t/ha). Crop yields after phases of these pasture legume species were similar or higher than those following subterranean clover or annual medics. The results of this study suggest a single season of a legume-dominant pasture may provide sufficient organic N in the soil to grow at least one crop, without the need for inorganic N fertilizer application. This has implications for reducing inorganic N requirements and the carbon footprint of cropping in dryland agricultural systems.
The first demonstration of laser action in ruby was made in 1960 by T. H. Maiman of Hughes Research Laboratories, USA. Many laboratories worldwide began the search for lasers using different materials, operating at different wavelengths. In the UK, academia, industry and the central laboratories took up the challenge from the earliest days to develop these systems for a broad range of applications. This historical review looks at the contribution the UK has made to the advancement of the technology, the development of systems and components and their exploitation over the last 60 years.
For forty years, successive editions of Ethical Theory and Business have helped to define the field of business ethics. The 10th edition reflects the current, multidisciplinary nature of the field by explicitly embracing a variety of perspectives on business ethics, including philosophy, management, and legal studies. Chapters integrate theoretical readings, case studies, and summaries of key legal cases to guide students to a rich understanding of business ethics, corporate responsibility, and sustainability. The 10th edition has been entirely updated, ensuring that students are exposed to key ethical questions in the current business environment. New chapters cover the ethics of IT, ethical markets, and ethical management and leadership. Coverage includes climate change, sustainability, international business ethics, sexual harassment, diversity, and LGBTQ discrimination. New case studies draw students directly into recent business ethics controversies, such as sexual harassment at Fox News, consumer fraud at Wells Fargo, and business practices at Uber.