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The wellbeing neuro course: a randomised controlled trial of an internet-delivered transdiagnostic psychological intervention for adults with neurological disorders
- Milena Gandy, Andreea I. Heriseanu, Tanya Balakumar, Eyal Karin, Jennie Walker, Taylor Hathway, Madelyne A. Bisby, Amelia J. Scott, Joanne Dudeney, Alana Fisher, Nickolai Titov, Blake F. Dear
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- Journal:
- Psychological Medicine / Volume 53 / Issue 14 / October 2023
- Published online by Cambridge University Press:
- 01 March 2023, pp. 6817-6827
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- Article
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Background
Mental health and functional difficulties are highly comorbid across neurological disorders, but supportive care options are limited. This randomised controlled trial assessed the efficacy of a novel transdiagnostic internet-delivered psychological intervention for adults with neurological disorders.
Methods221 participants with a confirmed diagnosis of epilepsy, multiple sclerosis, Parkinson's disease, or an acquired brain injury were allocated to either an immediate treatment group (n = 115) or treatment-as-usual waitlist control (n = 106). The intervention, the Wellbeing Neuro Course, was delivered online via the eCentreClinic website. The Course includes six lessons, based on cognitive behavioural therapy, delivered over 10 weeks with support from a psychologist via email and telephone. Primary outcomes were symptoms of depression (PHQ-9), anxiety (GAD-7) and disability (WHODAS 2.0).
Results215 participants commenced the trial (treatment n = 111; control n = 104) and were included in intention-to-treat analysis. At post-treatment, we observed significant between-group differences in depression (PHQ-9; difference = 3.07 [95% CI 2.04–4.11], g = 0.62), anxiety (GAD-7; difference = 1.87 [0.92–2.81], g = 0.41) and disability (WHODAS 2.0 difference = 3.08 [1.09–5.06], g = 0.31), that favoured treatment (all ps < 0.001). Treatment-related effects were maintained at 3-month follow-up. Findings were achieved with minimal clinician time (average of 95.7 min [s.d. = 59.3] per participant), highlighting the public health potential of this approach to care. No adverse treatment events were reported.
ConclusionsInternet-delivered psychological interventions could be a suitable model of accessible supportive care for patients with neurological disorders.
Preface to the Series Perspectives in Mathematical Logic
- Manuel Lerman, University of Connecticut
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- Book:
- Degrees of Unsolvability
- Published online:
- 31 March 2017
- Print publication:
- 06 April 2017, pp vii-viii
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Summary
On Perspectives. Mathematical logic arose from a concern with the nature and the limits of rational or mathematical thought, and from a desire to systematise the modes of its expression. The pioneering investigations were diverse and largely autonomous. As time passed, and more particularly in the last two decades, interconnections between different lines of research and links with other branches of mathematics proliferated. The subject is now both rich and varied. It is the aim of the series to provide, as it were, maps or guides to this complex terrain. We shall not aim at encyclopaedic coverage', nor do we wish to prescribe, like Euclid, a definitive version of the elements of the subject. We are not committed to any particular philosophical programme. Nevertheless we have tried by critical discussion to ensure that each book represents a coherent line of thought', and that, by developing certain themes, it will be of greater interest than a mere assemblage of results and techniques.
The books in the series differ in level: some are introductory, some highly specialised. They also differ in scope: some offer a wide view of an area, others present a single line of thought. Each book is, at its own level, reasonably self-contained. Although no book depends on another as prerequisite, we have encouraged authors to fit their book in with other planned volumes, sometimes deliberately seeking coverage of the same material from different points of view. We have tried to attain a reasonable degree of uniformity of notation and arrangement. However, the books in the series are written by individual authors, not by the group. Plans for books are discussed and argued about at length. Later, encouragement is given and revisions suggested. But it is the authors who do the work', if, as we hope, the series proves of value, the credit will be theirs.
History of the Q-Group. During 1968 the idea of an integrated series of monographs on mathematical logic was first mooted. Various discussions led to a meeting at Oberwolfach in the spring of 1969. Here the founding members of the group (R. O. Gandy, A. Levy, G. H. Mu'ller, G. E. Sacks, D. S. Scott) discussed the project in earnest and decided to go ahead with it. Professor F. K. Schmidt and Professor Hans Hermes gave us encouragement and support.
Preface to the Series
- Jens E. Fenstad, Universitetet i Oslo
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- Book:
- General Recursion Theory
- Published online:
- 31 March 2017
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- 02 March 2017, pp v-vi
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Summary
On Perspectives. Mathematical logic arose from a concern with the nature and the limits of rational or mathematical thought, and from a desire to systematise the modes of its expression. The pioneering investigations were diverse and largely autonomous. As time passed, and more particularly in the last two decades, interconnections between different lines of research and links with other branches of mathematics proliferated. The subject is now both rich and varied. It is the aim of the series to provide, as it were, maps or guides to this complex terrain. We shall not aim at encyclopaedic coverage; nor do we wish to prescribe, like Euclid, a definitive version of the elements of the subject. We are not committed to any particular philosophical programme. Nevertheless we have tried by critical discussion to ensure that each book represents a coherent line of thought; and that, by developing certain themes, it will be of greater interest than a mere assemblage of results and techniques.
The books in the series differ in level: some are introductory some highly specialised. They also differ in scope: some offer a wide view of an area, others present a single line of thought. Each book is, at its own level, reasonably self contained. Although no book depends on another as prerequisite, we have encouraged authors to fit their book in with other planned volumes, sometimes deliberately seeking coverage of the same material from different points of view. We have tried to attain a reasonable degree of uniformity of notation and arrangement. However, the books in the series are written by individual authors, not by the group. Plans for books are discussed and argued about at length. Later, encouragement is given and revisions suggested. But it is the authors who do the work; if as we hope, the series proves of value, the credit will be theirs.
History of the Ω-Group. During 1968 the idea of an integrated series of monographs on mathematical logic was first mooted. Various discussions led to a meeting at Oberwolfach in the spring of 1969. Here the founding members of the group (R. O. Gandy, A. Levy, G. H. Muller, G. E. Sacks, D. S. Scott) discussed the project in earnest and decided to go ahead with it. Professor F. K. Schmidt and Professor Hans Hermes gave us encouragement and support.
Preface to the Series Perspectives in Mathematical Logic
- Petr Hájek, Academy of Sciences of the Czech Republic, Prague, Pavel Pudlák, Academy of Sciences of the Czech Republic, Prague
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- Book:
- Metamathematics of First-Order Arithmetic
- Published online:
- 24 March 2017
- Print publication:
- 02 March 2017, pp vii-viii
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Summary
On Perspectives. Mathematical logic arouse from a concern with the nature and the limits of rational or mathematical thought, and from a desire to systematise the modes of its expression. The pioneering investigations were diverse and largely autonomous. As time passed, and more particularly in the last two decades, interconnections between different lines of research and links with other branches of mathematics proliferated. The subject is now both rich and varied. It is the aim of the series to provide, as it were, maps of guides to this complex terrain. We shall not aim at encyclopaedic coverage: nor do we wish to prescribe, like Euclid, a definitive version of the elements of the subject. We are not committed to any particular philosophical programme. Nevertheless we have tried by critical discussion to ensure that each book represents a coherent line of thought; and that, by developing certain themes, it will be of greater interest than a mere assemblage of results and techniques.
The books in the series differ in level: some are introductory, some highly specialised. They also differ in scope: some offer a wide view of an area, others present a single line of thought. Each book is, at its own level, reasonably self-contained. Although no book depends on another as prerequisite, we have encouraged authors to fit their books with other planned volumes, sometimes deliberately seeking coverage of the same material from different points of view. We have tried to attain a reasonable degree of uniformity of notation and arrangement. However, the books in the series are written by individual authors, not by the group. Plans for books are discussed and argued about at length. Later, encouragement is given and revisions suggested. But it is the authors who do the work; if, as we hope, the series proves of values, the credit will be theirs.
History of the fi-Group. During 1968 the idea of an integrated series of monographs on mathematical logic was first mooted. Various discussions led to a meeting at Oberwolfach in the spring of 1969. Here the founding members of the group (R.O. Gandy, A. Levy, G.H. Mu'ller, G. Sacks, D.S. Scott) discussed the project in earnest and decided to go ahead with it. Professor F.K. Schmidt and Professor Hans Hermes gave us encouragement and support.
Preface to the Serie
- Jon Barwise, University of Wisconsin, Madison
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- Book:
- Admissible Sets and Structures
- Published online:
- 31 March 2017
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- 02 March 2017, pp vii-viii
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Summary
On Perspectives. Mathematical logic arose from a concern with the nature and the limits of rational or mathematical thought, and from a desire to systematise the modes of its expression. The pioneering investigations were diverse and largely autonomous. As time passed, and more particularly in the last two decades, interconnections between different lines of research and links with other branches of mathematics proliferated. The subject is now both rich and varied. It is the aim of the series to provide, as it were, maps or guides to this complex terrain. We shall not aim at encyclopaedic coverage; nor do we wish to prescribe, like Euclid, a definitive version of the elements of the subject. We are not committed to any particular philosophical programme. Nevertheless we have tried by critical discussion to ensure that each book represents a coherent line of thought; and that, by developing certain themes, it will be of greater interest than a mere assemblage of results and techniques.
The books in the series differ in level: some are introductory some highly specialised. They also differ in scope: some offer a wide view of an area, others present a single line of thought. Each book is, at its own level, reasonably self-contained. Although no book depends on another as prerequisite, we have encouraged authors to fit their book in with other planned volumes, sometimes deliberately seeking coverage of the same material from different points of view. We have tried to attain a reasonable degree of uniformity of notation and arrangement. However, the books in the series are written by individual authors, not by the group. Plans for books are discussed and argued about at length. Later, encouragement is given and revisions suggested. But it is the authors who do the work; if, as we hope, the series proves of value, the credit will be theirs.
Preface to the Series Perspectives in Mathematic Logic
- Gerald E. Sacks, Harvard University, Massachusetts
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- Book:
- Higher Recursion Theory
- Published online:
- 24 March 2017
- Print publication:
- 02 March 2017, pp vii-viii
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Summary
On Perspectives. Mathematical logic arose from a concern with the nature and the limits of rational or mathematical thought, and from a desire to systematise the modes of its expression. The pioneering investigations were diverse and largely autonomous. As time passed, and more particularly in the last two decades, interconnections between different lines of research and links with other branches of mathematics proliferated. The subject is now both rich and varied. It is the aim of the series to provide, as it were, maps of guides to this complex terrain. We shall not aim at encyclopaedic coverage; nor do we wish to prescribe, like Euclid, a definitive version of the elements of the subject. We are not committed to any particular philosophical programme. Nevertheless we have tried by critical discussion to ensure that each book represents a coherent line of thought; and that, by developing certain themes, it will be of greater interest than a mere assemblage of results and techniques.
The books in the series differ in level: some are introductory, some highly specialised. They also differ in scope: some offer a wide view of an area, others present a single line of thought. Each book is, at its own level, reasonably selfcontained. Although no book depends on another as prerequisite, we have encouraged authors to fit their book with other planned volumes, sometimes deliberately seeking coverage of the same material from different points of view. We have tried to attain a reasonable degree of uniformity of notation and arrangement. However, the books in the series are written by individual authors, not by the group. Plans for books are discussed and argued about at length. Later, encouragement is given and revisions suggested. But it is the authors who do the work; if, as we hope, the series proves of values, the credit will be theirs.
History of the Group. During 1968 the idea of an integrated series of monographs on mathematical logic was first mooted. Various discussions led to a meeting at Oberwolfach in the spring of 1969. Here the founding members of the group (R.O. Gandy, A. Levy, G.H. Muller, G. Sacks, D.S. Scott) discussed the project in earnest and decided to go ahead with it. Professor F.K. Schmidt and Professor Hans Hermes gave us encouragement and support. Later Hans Hermes joined the group.
Prepartum milking effects on parlour behaviour, endocrine and immune responses in Holstein heifers
- Susan D Eicher, Michael Schutz, Francis Kearney, Scott Willard, Susan Bowers, Scott Gandy, Kenneth Graves
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- Journal:
- Journal of Dairy Research / Volume 74 / Issue 4 / November 2007
- Published online by Cambridge University Press:
- 26 July 2007, pp. 417-424
- Print publication:
- November 2007
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Transition of primiparous heifers to the milking herd is a period with multiple stressors. The objective of these studies was to determine effects of parlour experience and prepartum milking (pre-milking) on behavioural and physiological indicators of stress after calving. Two experiments were conducted, one was in a free-stall housing confinement system and the second was in a modified grazing system. Forty-eight first-calf heifers were assigned to three treatments: control; experienced heifers taken through the parlour without milking; or pre-milk heifers milked for 3 weeks prior to estimated parturition. Blood was collected within 24 h of parturition and on days 3, 5, 7, 10 and 14 following parturition for cortisol and acute phase protein determination. In the grazing system, 20 heifers were assigned to a prepartum milked or control group as in the confinement system and behaviour observations included days −21, −14, −7, −5, −3 and −1 relative to calving and days 1, 3, 7, 9, 14, and 16 post-calving. Milk production was greatest for prepartum milked heifers in both housing systems. However, somatic cell score was reduced by prepartum milking only in the confinement system. Balking occurred least in parlour-experienced heifers. In confinement housing, shifting while in the parlour was the only behaviour that was greater at first milking in control heifers. Kicking was most frequent for parlour experienced heifers on day 2. Grazing system pre-milked heifers shifted more at their first milking (day −21) than did the controls at their first milking (day 1). Shifting within cow was greatest on day −21 compared with day −5 (P<0·05). Pre-milked heifers shifted more on day 1 post-calving than did the control heifers (P<0·05). These results showed that shifting was the most indicative behaviour of restlessness, was transient, and decreased by day 5 prior to calving. Cortisol and α1-acid glycoprotein concentrations were not different; however, haptoglobin increased for all treatments up to and including day 3 and haptoglobin concentrations of pre-milked heifers began to decrease by day 5 post-calving. Pre-milked heifers had lower haptoglobin concentrations than the control heifers and tended to have lower concentrations than experienced heifers on day 10 post partum. By day 14 post partum, all haptoglobin concentrations were <200 μg/ml, but the haptoglobin concentration of control heifers was greater than that of pre-milked and experienced heifers. These results showed that prepartum milking and parlour experience shorten some acute phase protein responses, but minimally affect early parlour behaviours.
Effects of prepartum milking on postpartum reproduction, udder health and production performance in first-calf dairy heifers
- Susan Bowers, Scott Gandy, Kenneth Graves, Susan Eicher, Scott Willard
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- Journal:
- Journal of Dairy Research / Volume 73 / Issue 3 / August 2006
- Published online by Cambridge University Press:
- 29 March 2006, pp. 257-263
- Print publication:
- August 2006
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Postpartum production performance of dairy heifers may be enhanced by prepartum milking by alleviating the stress of the periparturient period. The objective of this study was to determine the impact of prepartum milking of dairy heifers on postpartum reproduction, udder health, milk production and other associated production characteristics. Pregnant heifers (Holstein, n=21; Jersey n=10) were assigned to either a prepartum milked (premilked, n=15) or control (n=16) group. Premilked heifers were milked twice daily starting 3 weeks prior to anticipated calving dates, and milk yield recorded at each milking. All heifers were evaluated on days 21, 14 and 7 before calving, and udder oedema scores and milk conductivity readings were recorded. Following calving, measurements were taken twice weekly to assess udder oedema, milk conductivity (indicative of udder infection), and reproductive health, which included palpation for uterine tone and uterine position, vaginal electrical impedance (VEI) and the quantification of cross-sectional area of the uterine horns (uterine difference) by transrectal ultrasonography. Uterine tone, uterine position, uterine difference, and VEI did not differ (P>0·10) with treatment. Overall, up to week six inclusive, postpartum premilked heifers had lower (P<0·01) udder oedema scores than control heifers and up to week five inclusive, had lower (P<0·01) milk conductivity readings (indicative of fewer incidences of udder infections) than control heifers. The premilked heifers of both breeds produced more milk (P<0·01) at calving and more milk overall from calving to day 60 postpartum than the control heifers. In summary, udder health and milk production were improved post calving in premilked heifers compared with controls. However, no overt differences in reproductive characteristics were observed between the premilked and control heifers.