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Research in optics and photonics, in parallel with the rapid development of nanoscience, has driven advancements within many fields of contemporary science and technology, allowing nano-optics to flourish as a research field. This authoritative text provides a comprehensive and accessible account of this important topic, beginning with the theoretical foundations of light localization and the propagation and focusing of optical fields, before progressing to more advanced topics such as near-field optics, surface plasmons in noble metals, metamaterials, and quantum emitters. Now in its third edition, the book has been substantially restructured, expanded, and developed to include additional problem sets and important topics such as super-resolution microscopy, random media, and coupled-mode theory. It remains an essential resource for graduate students and researchers working in photonics, optoelectronics, and nano-optics.
Rational Emotive Behavior Therapy (REBT) fundamentally posits that our thoughts, beliefs, and interpretations exert substantial influence over how we perceive and react to life’s occurrences. Central to REBT is the process of recognizing and disputing irrational, self-defeating beliefs, in favor of adopting rational and constructive perspectives.
Objectives
This presentation endeavors to introduce the foundational principles of REBT, elucidate its applied techniques, demonstrate its efficacy through compelling case studies, and delineate its spheres of applicability.
Methods
Case Studies:
1. Overcoming Social Anxiety: Illustrating the transformation from debilitating social anxiety to enhanced social functioning.
2. Managing Work-related Stress: Exemplifying the alleviation of chronic stress in a high-pressure work environment.
3. Overcoming Depression: Demonstrating the journey from persistent despondency to restored vitality and engagement.
Results
In total, REBT furnishes a methodical and pragmatic approach to therapy, affording individuals agency in steering their emotional well-being towards positive and enduring transformation. It is imperative to acknowledge that the suitability of REBT hinges on the idiosyncratic needs, inclinations, and circumstances of each patient.
Conclusions
By internalizing and applying these foundational principles, REBT empowers individuals to identify and dispute irrational beliefs, paving the way for more adaptive emotional responses and an enhanced overall state of mental well-being. It equips individuals with tangible tools to navigate life’s challenges with heightened resilience and emotional equilibrium.
Although several studies have documented the impact of the COVID-19 pandemic on mental health, the long-term effects remain unclear.
Aims
To examine longitudinal changes in mental health before and during the consecutive COVID-19 waves in a well-established probability sample.
Method
An online survey was completed by the participants of the COVID-19 add-on study at four time points: pre-COVID-19 period (2014–2015, n = 1823), first COVID-19 wave (April to May 2020, n = 788), second COVID-19 wave (August to October 2020, n = 532) and third COVID-19 wave (March to April 2021, n = 383). Data were collected via a set of validated instruments, and analysed with latent growth models.
Results
During the pandemic, we observed a significant increase in stress levels (standardised β = 0.473, P < 0.001) and depressive symptoms (standardised β = 1.284, P < 0.001). The rate of increase in depressive symptoms (std. covariance = 0.784, P = 0.014), but not in stress levels (std. covariance = 0.057, P = 0.743), was associated with the pre-pandemic mental health status of the participants. Further analysis showed that secondary stressors played a predominant role in the increase in mental health difficulties. The main secondary stressors were loneliness, negative emotionality associated with the perception of COVID-19 disease, lack of resilience, female gender and younger age.
Conclusions
The surge in stress levels and depressive symptoms persisted across all three consecutive COVID-19 waves. This persistence is attributable to the effects of secondary stressors, and particularly to the status of mental health before the COVID-19 pandemic. Our findings reveal mechanisms underlying the surge in mental health difficulties during the COVID-19 waves, with direct implications for strategies promoting mental health during pandemics.
The University Clinic of Skopje – Skopje was part of two Horizon 2020 projects – IMPULSE and RECOVER-e that finished in December 2021. The advances in the field of community mental health in the capital of Skopje, the idea to combine the best aspects of the aforementioned projects and the need of continual implementation and research on an evidence-based community-based service delivery model for recovery-oriented care led to this study which aims to improve functioning, quality of life, and mental health outcomes for people with severe and enduring mental ill health, such as schizophrenia, bipolar disorder, severe depression.
Objectives
The objectives of the study are: - to design, implement and evaluate recovery-oriented care for people with severe mental illness in community settings using a psychosocial digital intervention - DIALOG+;- to recognize the value of experiential knowledge through inclusion of peer experts as members of community mental health teams;- to develop scale-up plans for national decision-makers, as informed by the intervention’s implementation and impact, for sustained implementation and scale up after the research study’s timeline.- to improve the conditions of people suffering from psychotic disorders and to overcome financial barriers encountered in the treatment of psychotic disorders in N. Macedonia.
Methods
DIALOG+ represents an affordable and effective intervention which has already demonstrated positive outcomes in previous research. This study involves the use of the DIALOG+ intervention during home visits, so that patients themselves can decide which aspects of their life that they would like to discuss and work on improving. DIALOG+ lets them rate 12 domains that are related to quality of life, such as physical health, relationships and employment. Patient decide which of these they would like to discuss in detail during the meeting. There is then a 4-step approach to help improve this aspect of their life, using the principles of solution-focused therapy. Researchers will collect information about demographic characteristics, quality of life, and symptoms in patients taking part in the study through the administration of questionnaires and clinical scales.
Results
The study is still in phase of completion. The results will be shown at the EPA Congress 2023.
Conclusions
Having the previous positive outcomes from IMPULSE and RECOVER-e, with this combined approach we expect even more improvement in functioning and better quality of life in patients suffering from severe and enduring mental ill health.
Mental health problems have increased internationally during the COVID-19 pandemic. However, most data stems from Western countries and there is a clear lack of prevalence rates and potential risk factors from Central and Eastern Europe.
Objectives
To investigate the point prevalence and to provide further information on risk factors of depressive and anxiety symptoms in adolescents and their caregivers in North Macedonia after the COVID-19 pandemic.
Methods
A cross-sectional survey study was conducted on adolescents and their caregivers through the school setting in different areas of North Macedonia. Survey items assessed symptoms of depression, anxiety, and respondents’ fear of COVID-19, as well as a number of risk factors, such as gender and living environment.
Results
506 adolescents and 492 caregivers completed the survey. Symptoms of depression and anxiety were mild to moderate in adolescents and their caregivers. Women and girls generally scored higher than men and boys, and adolescents in high school scored higher than those in elementary school. Prevalence rates for depression were 29.2% for adolescents and 10.4% for caregivers, while rates of anxiety were 23.7% for adolescents and 6.1% for caregivers.
Conclusions
This study provides a first insight into the mental health of adolescents and their caregivers after the COVID-19 pandemic in North Macedonia. Further research is required to investigate the relatively low reported rates of caregivers’ mental health problems compared to data from other countries.
According to World Alzheimer Report 2021, more that 55 million of people in the world suffer from dementia. And although age is the strongest known risk factor for dementia, dementia does not exclusively affect older people. Early onset dementia is defined as the onset of symptoms before the age of 65 years. Considering that people with early onset dementia are in the most productive period of their life and often exposed to stress, when the symptoms of depression or psychosis can appear linked to other psychiatric diagnose it is hard to think of dementia when it is in early stage.
Objectives
We present a case of a woman at age of 55, mother of one child, widow, with secondary school degree, employed as textile worker.
She was already on psychiatric treatment for five years diagnosed at first as Mixed anxiety and depressive disorder and after that as Major depressive disorder, single episode, severe with psychotic features. Her past treatment include Sertraline up to 100mg per day or Escitalopram up to 10mg per day and Olanzapine up to 10mg per day. But her condition was worsening progressive with cognitive decline and during serial stressful events in the family (the death of her husband and severe corona virus infection of her son).
At present time she was hospitalized with psychotic symptoms, confusion, paranoid ideas and hallucinations, dysfunctional in everyday activities.
Methods
The neuropsychological testing showed global reduction in cognitive-behavior status. The results of extended laboratory tests were in normal range. Brain MRI showed global cortical reduction with more specified atrophy in fronto-temporal lobes bilateral. SPECT analysis showed significant hypoperfusion in both hemispheres in frontal, parietal and temporal lobes. Cerebrospinal fluid examination showed decresed level of beta-amyloid-42 (281,6 pq/ml).
Results
The results confirmed the diagnose of dementia with early onset, but because of advanced stadium and insufficient family history it was not possible to make clinical diagonose of the type. Diagnose in the end of hospitalization was: Early onset dementia, M. Alzheimer frontal variant.
Conclusions
With the presented case we suggest that the clinicians need to be very careful in the cases of psychosis treated independently and explore the possibility that psychosis can be a symptom of Alzheimer desease. Our case suggest that we should consider the possibility of early onset AD in middle-aged patients whose first symptoms are depressive with psychotic features. In this respesct, psychiatris need to consider proper completion of AD diagnostic protocol including biomarkers analysis.
OBJECTIVES/GOALS: The purpose of this retrospective cohort study was to evaluate the impact of mental illness on first-time transcatheter aortic valve replacement (TAVR) and repeat TAVR (viv-AVR) outcomes including postoperative atrial fibrillation (POAF/AFL), as well as trends over time. METHODS/STUDY POPULATION: Using de-identified data reports from the New York Statewide Planning and Research Cooperative System (SPARCS) database from 2005-2018, multivariate logistics models were used to predict endpoints including POAF, the Society of Cardiothoracic surgeon (STS) endpoint (MM), and 30-day readmission (READMIT) in patients with and without mental illness. The TAVR procedure was approved for high-risk patients after 2012, and intermediate-risk patients after 2016, indicting a need to analyze the two populations separately. Multivariate analysis was only conducted on the first-time TAVR patients because of the small n in the viv-TAVR population. RESULTS/ANTICIPATED RESULTS: After 2012, 13.05% (1,810/13,870) of patients undergoing TAVR and 20.83% (15/72) undergoing viv-TAVR were diagnosed with a mental illness before the procedure. After 2016, 15.59% (1,485/9,524) TAVR patients and 20.00% (11/55) viv-TAVR patients had a preoperative diagnosis of mental illness. Multivariate analysis showed that mentally ill patients did not have significant differences in rates of POAF, 30-day readmission, and 30-day composite outcomes when compared to patients without mental illnesses following TAVR procedures after 2012 and 2016. Patients with POAF after both 2012 and 2016 were significantly less likely to be mentally ill, Black, and Hispanic. DISCUSSION/SIGNIFICANCE: Of the mentally ill patients who underwent TAVR, there was no significant difference in short-term outcomes after 2012 vs. 2016, compared to patients without mental illnesses. The small number of mentally ill patients undergoing TAVR may point to provider bias as a contributor to this high selectivity, and further evaluation would be of clinical use.
This article discusses the remarks by James Madison to Virginia’s ratifying convention in June 1788 as they relate to the Electoral College. Madison’s remarks in Richmond shed light on his rarely highlighted expectations of the workings of the Electoral College and provide insight into the Constitutional Convention’s debate on the legislative selection of the President.
DIALOG+ is a digital psychosocial intervention aimed at making routine meetings between patients and clinicians therapeutically effective. This study aimed to evaluate the cost-effectiveness of implementing DIALOG+ treatment for patients with psychotic disorders in five low- and middle-income countries in Southeast Europe alongside a cluster randomised trial.
Methods
Resource use and quality of life data were collected alongside the multi-country cluster randomised trial of 468 participants with psychotic disorders. Due to COVID-19 interruptions of the trial’s original 12-month intervention period, adjusted costs and quality-adjusted life years (QALYs) were estimated at the participant level using a mixed-effects model over the first 6 months only. We estimated the incremental cost-effectiveness ratio (ICER) with uncertainty presented using a cost-effectiveness plane and a cost-effectiveness acceptability curve. Seven sensitivity analyses were conducted to check the robustness of the findings.
Results
The average cost of delivering DIALOG+ was €91.11 per participant. DIALOG+ was associated with an incremental health gain of 0.0032 QALYs (95% CI –0.0015, 0.0079), incremental costs of €84.17 (95% CI –8.18, 176.52), and an estimated ICER of €26,347.61. The probability of DIALOG+ being cost-effective against three times the weighted gross domestic product (GDP) per capita for the five participating countries was 18.9%.
Conclusion
Evidence from the cost-effectiveness analyses in this study suggested that DIALOG+ involved relatively low costs. However, it is not likely to be cost-effective in the five participating countries compared with standard care against a willingness-to-pay threshold of three times the weighted GDP per capita per QALY gained.
In Southeast Europe (SEE) standard treatment of patients with psychosis is largely based on pharmacotherapy with psychosocial interventions rarely available. DIALOG+ is a digital psychosocial intervention designed to make routine care therapeutically effective. This trial simultaneously examined effectiveness of DIALOG+ versus standard care on clinical and social outcomes (Aim 1) and explored intervention fidelity (Aim 2).
Methods
A hybrid type II effectiveness–implementation, cluster-randomized trial was conducted in five SEE countries: Bosnia and Herzegovina, Kosovo*, Montenegro, North Macedonia, and Serbia. The intervention was offered to patients six times across 12 months instead of routine care. The outcomes were subjective quality of life (primary), clinical symptoms, satisfaction with services, and economic costs. Intervention fidelity was operationalized as adherence to the protocol in terms of frequency, duration, content, and coverage. Data were analyzed using multilevel regression.
Results
A total of 81 clinicians and 468 patients with psychosis were randomized to DIALOG+ or standard care. The intervention was delivered with high fidelity. The average number of delivered sessions was 5.5 (SD = 2.3) across 12 months. Patients in the intervention arm had better quality of life (MANSA) at 6 months (p = 0.03). No difference was found for other outcomes at 6 months. Due to disruptions caused by the COVID-19 pandemic, 12-month data were not interpretable.
Conclusions
DIALOG+ improved subjective quality of life of individuals with psychosis at 6 months (after four sessions), albeit with small effect size. The intervention has the potential to contribute to holistic care of patients with psychosis.
Angiostrongylus cantonensis is an invasive zoonotic nematode which causes eosinophilic meningitis in accidental hosts – vertebrates including humans – and is known to impact wildlife. Even though the parasite originates in Southeast Asia, it has spread worldwide, especially into fragile island ecosystems. The Canary Islands are a biodiversity hot spot with numerous endemic species affected by biological invasions. Among others, Rattus rattus and Rattus norvegicus threaten many endemic species by predation and may spread invasive pathogens, such as the rat lungworm A. cantonensis, which was first described in Tenerife in 2010. Since it is known that lizards can act as paratenic hosts for A. cantonensis and Gallotia galloti is a lizard abundant in Tenerife, the aim of this study was to reveal the role of these endemic lizards in the parasite's life cycle. Gallotia galloti were captured in Tegueste, Tenerife, and after euthanasia, liver and tail muscle samples were examined for the presence of A. cantonensis. During microscopic examination, 8/36 liver samples (22.2%) contained granulomas with nematode larvae. In total, 10/39 liver samples (25.6%) and 7/36 tail muscle samples (19.4%) were positive for A. cantonensis DNA using qPCR. This is a first report of a reptile endemic to the Canary Islands acting as paratenic host of A. cantonensis. The fact that the parasite is obviously well-established in the island ecosystem and exploits endemic lizards as hosts may have important implications for the parasite's ecoepidemiology. Moreover, the parasite might threaten other species which depend on lizards in the island trophic web.
Although patient and carer involvement in research is well-developed in many countries, this area has been largely overlooked in South-East European countries.
Aims
To explore experiences of patients participating in newly set up lived experience advisory panels (LEAPs) within a European Commission funded, large-scale, multi-country mental health research project that focused on improving treatment of individuals with psychosis.
Method
Twenty-one mental health patients were individually interviewed across five countries: Bosnia and Herzegovina, Kosovo, Montenegro, North Macedonia and Serbia. Topic guides covered the experience of participating in LEAPs and their sustainability. Data were analysed by framework analysis.
Results
Seven themes were identified about participating in LEAPs: predominantly positive evaluation, high levels of participant motivation, therapeutic benefits for participants, few challenges, various future perspectives, positive appraisal of the research project and mixed reflections on mental healthcare. Overall, patients’ experiences were positive and enabled them to feel empowered. Patients expressed interest in remaining involved in advisory panels. Additionally, they felt that they could potentially contribute to the work of non-government organisations.
Conclusions
This study is among the few studies exploring patient participation in research projects, and the first such study conducted in South-East European countries. Patients are highly motivated for this engagement, which has the potential to empower them to take on new social roles. Significant efforts at the national level are needed in each country, to make patient involvement in research standard practice.
For the first time in N. Macedonia we had the experience to include peer workers as an equal members in the newly formed community mental health teams. For the purpose of the RECOVER-e project we engaged 2 patients to be the new peer workers.
Objectives
To evaluate the initial period of peer worker involvement in the community mental health teams and to identify the next steps for them.
Methods
Conducting interviews with the peer workers.
Results
One important aspect that is worth mentioning is their motivation to continue their work in the community mental health teams and continue to improve. Another finding is their will to establish a user led organisation. A user led organisation in the field of mental health in our country is rare to be find, with only a couple of them functioning in N. Macedonia. So if our peer workers can make it, it would be a great step in the right direction.
Conclusions
Overall, taking into consideration all that the peer workers have achieved in the last period, including the ups and downs of being the first official peer workers in N. Macedonia, they are looking forward to improve their knowledge and continue building their practical experience. A great plus of it all is that they have a financial stability for this troubled pandemic period.
Recent excavations at the site of Gallon Jug, a minor center in northwestern Belize, revealed multiple patolli boards incised into a well-preserved plaster floor in an unvaulted platform. A significant artifact deposit was placed directly on top of the patolli boards. In this report we describe the architectural context, associated artifact deposit, and the patolli boards themselves.
For non-probabilistic programs, a key question in static analysis is termination, which asks whether a given program terminates under a given initial condition. In the presence of probabilistic behaviour, there are two fundamental extensions of the termination question: (a) the almost-sure termination question, which asks whether the termination probability is 1; and (b) the bounded-time termination question, which asks whether the expected termination time is bounded. There are many active research directions to address these two questions; one important such direction is the use of martingale theory for termination analysis. In this chapter, we survey the main techniques of the martingale-based approach to the termination analysis of probabilistic programs.
To examine children’s sugar-sweetened beverage (SSB) and water intakes in relation to implemented intervention activities across the social ecological model (SEM) during a multilevel community trial.
Design:
Children’s Healthy Living was a multilevel, multicomponent community trial that reduced young child obesity (2013–2015). Baseline and 24-month cross-sectional data were analysed from nine intervention arm communities. Implemented intervention activities targeting reduced SSB and increased water consumption were coded by SEM level (child, caregiver, organisation, community and policy). Child SSB and water intakes were assessed by caregiver-completed 2-day dietary records. Multilevel linear regression models examined associations of changes in beverage intakes with activity frequencies at each SEM level.
Setting:
US-Affiliated Pacific region.
Participants:
Children aged 2–8 years (baseline: n 1343; 24 months: n 1158).
Results:
On average (± sd), communities implemented 74 ± 39 SSB and 72 ± 40 water activities. More than 90 % of activities targeted both beverages together. Community-level activities (e.g. social marketing campaign) were most common (61 % of total activities), and child-level activities (e.g. sugar counting game) were least common (4 %). SSB activities across SEM levels were not associated with SSB intake changes. Additional community-level water activities were associated with increased water intake (0·62 ml/d/activity; 95 % CI: 0·09, 1·15) and water-for-SSB substitution (operationalised as SSB minus water: –0·88 ml/d/activity; 95 % CI: –1·72, –0·03). Activities implemented at the organization level (e.g. strengthening preschool wellness guidelines) and policy level (e.g. SSB tax advocacy) also suggested greater water-for-SSB substitution (P < 0·10).
Conclusions:
Community-level intervention activities were associated with increased water intake, alone and relative to SSB intake, among young children in the Pacific region.
Healthcare services are increasingly confronted with challenges related to old age mental disorders. The survey aimed to provide an overview of existing psychogeriatric services in Albania, Bulgaria, Greece, and North Macedonia.
Methods
After identification of psychogeriatric units across the four countries, their head physicians were asked to provide data on their clinical, teaching, and research activity, as well as staff composition. Moreover, the attitudes of head physicians to current needs and future service development were explored.
Results
A total of 15 psychogeriatric units were identified (3 in Bulgaria, 8 in Greece, and 4 in North Macedonia). Results show wide variation regarding the location, team size and composition, service availability, numbers of patients attending, and inpatient treatment length. Most head physicians underscored the urgent need for breakthroughs in the graduate and postgraduate education in psychogeriatrics of medical and nonmedical professionals, as well as in the interconnection of their units with community primary healthcare services and long-term care facilities for seniors via telemedicine. They would welcome the development of national standards for psychogeriatric units, potentially embodying clear pointers for action. A number of head physicians advocated the development of nationwide old age mental health registries.
Conclusions
Regional disparities in resources and services for seniors’ mental health services were unveiled. These data may enrich the dialogue on optimizing psychogeriatric services through planning future cross-border collaborations mainly based on telemedicine services, especially in the era of the novel coronavirus pandemic, and training/education in psychogeriatrics of mental health professionals.
Key features and applications of a unique atomic force microscope (AFM), the LiteScope™, which can be integrated into a scanning electron microscope (SEM) is reported. Using the AFM-in-SEM as one tool combines the capabilities of both systems in a very efficient way. The LiteScope design features advanced Correlative Probe and Electron Microscopy (CPEM)™ imaging technology that allows simultaneous acquisition of multiple AFM and SEM signals and their precise in-time correlation into a 3D CPEM view. AFM-in-SEM advantages are presented using several examples of applications and AFM measurement modes including CPEM, material electrical and mechanical properties together with nanoindentation, and focused ion beam (FIB) applications.