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Motor neuron disease (MND) is a progressive, fatal, neurodegenerative condition that affects motor neurons in the brain and spinal cord, resulting in loss of the ability to move, speak, swallow and breathe. Acceptance and commitment therapy (ACT) is an acceptance-based behavioural therapy that may be particularly beneficial for people living with MND (plwMND). This qualitative study aimed to explore plwMND’s experiences of receiving adapted ACT, tailored to their specific needs, and therapists’ experiences of delivering it.
Method:
Semi-structured qualitative interviews were conducted with plwMND who had received up to eight 1:1 sessions of adapted ACT and therapists who had delivered it within an uncontrolled feasibility study. Interviews explored experiences of ACT and how it could be optimised for plwMND. Interviews were audio recorded, transcribed and analysed using framework analysis.
Results:
Participants were 14 plwMND and 11 therapists. Data were coded into four over-arching themes: (i) an appropriate tool to navigate the disease course; (ii) the value of therapy outweighing the challenges; (iii) relevance to the individual; and (iv) involving others. These themes highlighted that ACT was perceived to be acceptable by plwMND and therapists, and many participants reported or anticipated beneficial outcomes in the future, despite some therapeutic challenges. They also highlighted how individual factors can influence experiences of ACT, and the potential benefit of involving others in therapy.
Conclusions:
Qualitative data supported the acceptability of ACT for plwMND. Future research and clinical practice should address expectations and personal relevance of ACT to optimise its delivery to plwMND.
Key learning aims
(1) To understand the views of people living with motor neuron disease (plwMND) and therapists on acceptance and commitment therapy (ACT) for people living with this condition.
(2) To understand the facilitators of and barriers to ACT for plwMND.
(3) To learn whether ACT that has been tailored to meet the specific needs of plwMND needs to be further adapted to potentially increase its acceptability to this population.
Although the link between alcohol involvement and behavioral phenotypes (e.g. impulsivity, negative affect, executive function [EF]) is well-established, the directionality of these associations, specificity to stages of alcohol involvement, and extent of shared genetic liability remain unclear. We estimate longitudinal associations between transitions among alcohol milestones, behavioral phenotypes, and indices of genetic risk.
Methods
Data came from the Collaborative Study on the Genetics of Alcoholism (n = 3681; ages 11–36). Alcohol transitions (first: drink, intoxication, alcohol use disorder [AUD] symptom, AUD diagnosis), internalizing, and externalizing phenotypes came from the Semi-Structured Assessment for the Genetics of Alcoholism. EF was measured with the Tower of London and Visual Span Tasks. Polygenic scores (PGS) were computed for alcohol-related and behavioral phenotypes. Cox models estimated associations among PGS, behavior, and alcohol milestones.
Results
Externalizing phenotypes (e.g. conduct disorder symptoms) were associated with future initiation and drinking problems (hazard ratio (HR)⩾1.16). Internalizing (e.g. social anxiety) was associated with hazards for progression from first drink to severe AUD (HR⩾1.55). Initiation and AUD were associated with increased hazards for later depressive symptoms and suicidal ideation (HR⩾1.38), and initiation was associated with increased hazards for future conduct symptoms (HR = 1.60). EF was not associated with alcohol transitions. Drinks per week PGS was linked with increased hazards for alcohol transitions (HR⩾1.06). Problematic alcohol use PGS increased hazards for suicidal ideation (HR = 1.20).
Conclusions
Behavioral markers of addiction vulnerability precede and follow alcohol transitions, highlighting dynamic, bidirectional relationships between behavior and emerging addiction.
Helium or neopentane can be used as surrogate gas fill for deuterium (D2) or deuterium-tritium (DT) in laser-plasma interaction studies. Surrogates are convenient to avoid flammability hazards or the integration of cryogenics in an experiment. To test the degree of equivalency between deuterium and helium, experiments were conducted in the Pecos target chamber at Sandia National Laboratories. Observables such as laser propagation and signatures of laser-plasma instabilities (LPI) were recorded for multiple laser and target configurations. It was found that some observables can differ significantly despite the apparent similarity of the gases with respect to molecular charge and weight. While a qualitative behaviour of the interaction may very well be studied by finding a suitable compromise of laser absorption, electron density, and LPI cross sections, a quantitative investigation of expected values for deuterium fills at high laser intensities is not likely to succeed with surrogate gases.
An engaging, comprehensive, richly illustrated textbook about the atmospheric general circulation, written by leading researchers in the field. The book elucidates the pervasive role of atmospheric dynamics in the Earth System, interprets the structure and evolution of atmospheric motions across a range of space and time scales in terms of fundamental theoretical principles, and includes relevant historical background and tutorials on research methodology. The book includes over 300 exercises and is accompanied by extensive online resources, including solutions manuals, an animations library, and an introduction to online visualization and analysis tools. This textbook is suitable as a textbook for advanced undergraduate and graduate level courses in atmospheric sciences and geosciences curricula and as a reference textbook for researchers.
The term atmospheric general circulation, as used in this book, connotes a statistical representation of the three‐dimensional, time varying flow in the global atmosphere, including the cycling of zonal momentum, energy, water vapor, and other trace constituents.
In this chapter, we revisit one of the classical topics of atmospheric dynamics: the maintenance of the zonal mean zonal flow relative to the rotating Earth.
On a rotating planet, the zonally symmetric zonal wind and temperature fields are in thermal wind balance. By applying this dynamical constraint, it is possible to go beyond the consistency arguments for steady state balances in Eqs. (3.21) and (5.20) and deduce how the flow will evolve in response to specified, time varying distributions of diabatic heating rate, frictional drag, and the eddy transports of zonal momentum and heat. In this zonally averaged version of the primitive equations, which dates back to Eliassen,1 the mean meridional circulations play a critical role in enforcing the constraint that the zonal wind and temperature fields remain in thermal wind balance as the flow evolves.
This chapter introduces some of the fundamental concepts that underlie our understanding of the general circulation of planetary atmospheres: radiative–convective equilibrium, a mechanical energy cycle, a thermodynamic heat engine, stratification – how it develops and why it matters, the dynamical response to horizontal and vertical heating gradients, the influence of rotation, the far‐reaching effects of frictional drag.
Wave–mean flow interaction has played a central role in studies of the general circulation, dating back to the foundational works of Rossby, Starr, and collaborators. In the early studies the waves were usually referred to as “eddies” (as in “turbulent eddies”) without regard for the specific kind of instability or forcing mechanism that gave rise to them. Starr was particularly intrigued with the countergradient transports of angular momentum equatorward of the tropospheric jet stream.1
Parts II, III, and IV are exclusively concerned with the zonally averaged circulation. All representations of the eddies and the transports that they produce are based on zonally averaged statistics.
Total energy connotes the sum of the internal and mechanical (i.e., internal plus potential plus kinetic) energy, where the kinetic energy is ordinarily neglected, as justified in Exercise 5.4. Observational studies of the long‐term mean global energy balance dating back to the 1950s demonstrate the central role of the poleward eddy heat transports. Using space‐based measurements of radiative fluxes through the top of the atmosphere, it is now possible to partition the total poleward transport of energy between the atmosphere and the oceans and to monitor seasonal and nonseasonal variations in energy storage in the oceans.
The total energy per unit mass of an air parcel is the sum of its internal, potential, and kinetic energy. It can be shown (see Exercise 6.1) that integrated over a column of unit area, the sum of the potential plus internal energy is given by .
The first studies of the mass balance of atmospheric trace constituents were focused on water vapor. The earliest of these studies were motivated by the fact that the release of latent heat of condensation in precipitation is an important heat source in the global energy budget, the subject of Chapter 5. These early studies also provided new insights into the hydrologic cycle, particularly over land, and were helpful in explaining the observed salinity distribution in the ocean.
Part I consists of two chapters. The first describes the observational basis for general circulation, documents its salient features, and introduces the reader to the kinds of models that are being used to simulate it.
When plotted as partial zonal averages in Fig. 16.1, the seasonality of the zonal mean circulation in the eastern and western hemispheres of the tropics is quite different. In the eastern hemisphere (from the Greenwich Meridian eastward to the Date Line), the zonal mean circulation is dominated by the seasonally reversing Australasian monsoon, which is strong and nearly synchronous with the annual cycle in the meridional profile of insolation. In contrast, in the western hemisphere, the seasonality is not as pronounced and the annual cycle is lagged by about two months relative to the solstices.