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Young people with social disability and severe and complex mental health problems have poor outcomes, frequently struggling with treatment access and engagement. Outcomes may be improved by enhancing care and providing targeted psychological or psychosocial intervention.
Aims
We aimed to test the hypothesis that adding social recovery therapy (SRT) to enhanced standard care (ESC) would improve social recovery compared with ESC alone.
Method
A pragmatic, assessor-masked, randomised controlled trial (PRODIGY: ISRCTN47998710) was conducted in three UK centres. Participants (n = 270) were aged 16–25 years, with persistent social disability, defined as under 30 hours of structured activity per week, social impairment for at least 6 months and severe and complex mental health problems. Participants were randomised to ESC alone or SRT plus ESC. SRT was an individual psychosocial therapy delivered over 9 months. The primary outcome was time spent in structured activity 15 months post-randomisation.
Results
We randomised 132 participants to SRT plus ESC and 138 to ESC alone. Mean weekly hours in structured activity at 15 months increased by 11.1 h for SRT plus ESC (mean 22.4, s.d. = 21.4) and 16.6 h for ESC alone (mean 27.7, s.d. = 26.5). There was no significant difference between arms; treatment effect was −4.44 (95% CI −10.19 to 1.31, P = 0.13). Missingness was consistently greater in the ESC alone arm.
Conclusions
We found no evidence for the superiority of SRT as an adjunct to ESC. Participants in both arms made large, clinically significant improvements on all outcomes. When providing comprehensive evidence-based standard care, there are no additional gains by providing specialised SRT. Optimising standard care to ensure targeted delivery of existing interventions may further improve outcomes.
Rectal colonization with multidrug-resistant Enterobacteriaceae was found in 23 of 94 consecutively enrolled international patients hospitalized at Mayo Clinic, Rochester, Minnesota. No carbapenemase producers were detected. Twenty-one isolates were extended-spectrum β-lactamase-producing Escherichia coli. Colonization was associated with gastrointestinal disease and central venous catheter placement within the antecedent year.
Background: Recent research has indicated that individuals with social interaction anxiety make biased interpretations of positive social interactions, with greater general apprehension in response to such events and more negative predictions about the future. There has also been some preliminary evidence for a second facet of interpretation bias, namely a failure to accept others’ positive reactions at face value, but this has so far not been adequately studied. Method: The present study developed a new measure of this “discounting” dimension and utilized a nonclinical sample of undergraduate students to provide an initial analysis of the scale. Results: Results provide early support for the psychometric properties of our scale, and indicate that discounting mediates the relationship between social interaction anxiety and low positive affect, over and above the previously studied aspect of positive event interpretation bias. Conclusions: The implications for treatment interventions and further research are discussed.
Carpendale & Lewis (C&L) rightly emphasise the central role of social interaction in the development of children's understanding of mind. Further support and justification for their theoretical focus are provided by research on advanced reasoning about socio-emotional and socio-motivational processes. Variability in social experience can explain both developmental change and within-age-group differences in such social understanding.
The formation of an amorphous layer is needed to prevent channeling effect of B in the subsequent implant and hence, shallower as-implanted and annealed profiles could be expected. B diffusion in the pre-amorphization (PAI) Si has been studied extensively by many research groups and the diffusion has been explained by the interaction of B and defects generated by the PAI and B implant processes. In our previous study, we found that B diffusion can also be affected by the immobile B clustering caused by the incorporated species and therefore, B diffusion in the PAI Si should be expected to be different with different PAI species due to their different effect on the B clustering. In this paper, we reported different B diffusion behavior in bulk Si with respective to different PAI species. The species include GeF2, Ge, F, BF2, and In and the immobile B clustering plays an important role in the B diffusion reduction.